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General NPI Number Information
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NPI Number | 1225830805
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Entity Type | Organization
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Legal Business Name | ELM CREEK HEALTHCARE INC
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Dates
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Enumeration Date | 03/25/2025
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 1650 W END BLVD STE 100
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City | ST LOUIS PARK
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State | MN
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Zip | 55416-5369
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Country | US
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Telephone | 612-305-8260
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Fax | 763-207-1377
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Provider Business Mailing Address
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Address Line | 1650 W END BLVD STE 100
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City | ST LOUIS PARK
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State | MN
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Zip | 55416-5369
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Country | US
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Telephone | 612-305-8260
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Fax | 763-207-1377
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Authorized Official
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Title or Position | EXECUTIVE
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Name | ALISON WILLIAMS
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Credential |
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Telephone | 612-305-8260
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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