Healthcare Provider Details

I. General information

NPI: 1881767069
Provider Name (Legal Business Name): SPECTRUM COMMUNITY HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

418 9TH ST S
VIRGINIA MN
55792-2838
US

IV. Provider business mailing address

850 2ND ST NW
AITKIN MN
56431-1140
US

V. Phone/Fax

Practice location:
  • Phone: 218-741-3013
  • Fax:
Mailing address:
  • Phone: 218-260-2301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number334658
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number313695
License Number StateMN

VIII. Authorized Official

Name: HEATHER POTTER
Title or Position: VICE PRESIDENT OF OPERATIONS
Credential:
Phone: 218-927-2164