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General NPI Number Information
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NPI Number | 1043665904
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Entity Type | Organization
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Legal Business Name | GENTLE TOUCH HEALTH INITIATIVES, LLC
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Dates
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Enumeration Date | 04/28/2016
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Last Update Date | 04/28/2016
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Provider Practice Location Address
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Address Line | 10669 ULYSSES ST NE
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City | BLAINE
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State | MN
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Zip | 55434-3767
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Country | US
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Telephone | 763-754-7300
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Fax | 763-754-2561
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Provider Business Mailing Address
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Address Line | 10669 ULYSSES ST NE
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City | BLAINE
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State | MN
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Zip | 55434-3767
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Country | US
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Telephone | 763-754-7300
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Fax | 763-754-2561
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Authorized Official
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Title or Position | CEO
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Name | MR. MICHAEL B PAGH
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Credential |
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Telephone | 763-377-1800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 375259
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License Number State | MN
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