Healthcare Provider Details

I. General information

NPI: 1316994114
Provider Name (Legal Business Name): AMBER HOUSE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 CARDINAL DR
MANKATO MN
56001-6713
US

IV. Provider business mailing address

213 WOODHILL CT
MANKATO MN
56001-4773
US

V. Phone/Fax

Practice location:
  • Phone: 507-344-0209
  • Fax: 350-734-4020
Mailing address:
  • Phone: 507-388-9964
  • Fax: 507-388-2426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number1005205
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number1005246
License Number StateMN

VIII. Authorized Official

Name: MS. LOIS ANN PALMER
Title or Position: OWNER/ADMINISTRATOR
Credential:
Phone: 507-388-9964