Healthcare Provider Details

I. General information

NPI: 1902824402
Provider Name (Legal Business Name): ST. MICHAEL'S HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 12/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 ELM ST N
SAUK CENTRE MN
56378-1010
US

IV. Provider business mailing address

425 ELM ST N
SAUK CENTRE MN
56378-1010
US

V. Phone/Fax

Practice location:
  • Phone: 320-352-2221
  • Fax: 320-352-5150
Mailing address:
  • Phone: 320-352-2221
  • Fax: 320-352-5150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number7656850
License Number StateMN

VIII. Authorized Official

Name: MR. DELANO CHRISTIANSON
Title or Position: ADMINISTRATOR
Credential:
Phone: 320-352-2221