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General NPI Number Information
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NPI Number | 1083779169
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Entity Type | Organization
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Legal Business Name | NOBLES-ROCK COMMUNITY HEALTH SERVICES
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 315 10TH ST
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City | WORTHINGTON
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State | MN
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Zip | 56187-2315
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Country | US
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Telephone | 507-372-8256
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Fax |
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Provider Business Mailing Address
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Address Line | 315 10TH ST
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City | WORTHINGTON
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State | MN
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Zip | 56187-2315
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Country | US
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Telephone | 507-372-8256
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Fax |
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Authorized Official
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Title or Position | CHS ADMINISTRATOR
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Name | MR. BRAD MEYER
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Credential | MHA
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Telephone | 507-372-8256
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | 3486464
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License Number State | MN
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