Healthcare Provider Details

I. General information

NPI: 1609135003
Provider Name (Legal Business Name): BENEDICTINE CARE CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2012
Last Update Date: 03/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

213 PIONEER RD
RED WING MN
55066
US

IV. Provider business mailing address

213 PIONEER RD
RED WING MN
55066-3921
US

V. Phone/Fax

Practice location:
  • Phone: 651-388-1234
  • Fax: 651-385-3420
Mailing address:
  • Phone: 651-388-1234
  • Fax: 651-385-3420

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: TRICIA BERGIEN
Title or Position: DIRECTOR, REIMBURSEMENT AND PAYMENT
Credential:
Phone: 612-991-6519