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General NPI Number Information
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NPI Number | 1144345067
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Entity Type | Organization
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Legal Business Name | NORTH STAR NURSING TEMPORARY ASSOCIATES, INC.
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 07/21/2021
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Provider Practice Location Address
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Address Line | 22119 480TH AVE
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City | OSAGE
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State | MN
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Zip | 56570-9554
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Country | US
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Telephone | 218-573-2238
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Fax | 218-573-3778
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Provider Business Mailing Address
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Address Line | 22119 480TH AVE P.O. BOX 306
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City | OSAGE
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State | MN
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Zip | 56570-9554
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Country | US
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Telephone | 218-573-2238
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Fax | 218-573-3778
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MS. HEIDI ANN CLEMENTS
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Credential | LPN
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Telephone | 218-573-2238
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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 | 333705
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License Number State | MN
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