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General NPI Number Information
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NPI Number | 1083601843
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Entity Type | Organization
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Legal Business Name | CHARTERHOUSE INC
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Dates
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Enumeration Date | 10/05/2005
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Last Update Date | 03/23/2023
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Provider Practice Location Address
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Address Line | 211 2ND ST NW
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City | ROCHESTER
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State | MN
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Zip | 55901-2807
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Country | US
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Telephone | 507-266-8572
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Fax | 507-266-6827
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Provider Business Mailing Address
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Address Line | 211 2ND ST NW
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City | ROCHESTER
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State | MN
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Zip | 55901-2807
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Country | US
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Telephone | 507-266-8572
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Fax | 507-266-6827
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Authorized Official
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Title or Position | TREASURER/ ADMINISTRATOR
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Name | CHRISTOPHER DALE RUSTAD
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Credential |
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Telephone | 507-266-7862
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 327208
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License Number State | MN
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