Healthcare Provider Details

I. General information

NPI: 1457356206
Provider Name (Legal Business Name): ST. JOSEPH'S AREA HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2005
Last Update Date: 03/04/2020
Certification Date: 03/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 1ST ST E
PARK RAPIDS MN
56470-1803
US

IV. Provider business mailing address

600 PLEASANT AVE S
PARK RAPIDS MN
56470-1431
US

V. Phone/Fax

Practice location:
  • Phone: 218-237-5464
  • Fax: 218-237-5541
Mailing address:
  • Phone: 218-237-5464
  • Fax: 218-237-5541

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARLEE MORRISON
Title or Position: COMMUNITY HEALTH DIRECTOR
Credential: PHN
Phone: 218-237-5474