Healthcare Provider Details

I. General information

NPI: 1124025812
Provider Name (Legal Business Name): COMMUNITY MEMORIAL HOSPITAL & NURSING HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 MEMORIAL DR
SPRING VALLEY MN
55975-1024
US

IV. Provider business mailing address

800 MEMORIAL DR
SPRING VALLEY MN
55975-1024
US

V. Phone/Fax

Practice location:
  • Phone: 507-346-7381
  • Fax: 507-346-7619
Mailing address:
  • Phone: 507-346-7381
  • Fax: 507-346-7619

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: PENNY SOLBERG
Title or Position: ADMINISTRATOR
Credential: MBA
Phone: 507-346-7381