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General NPI Number Information
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NPI Number | 1255445581
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Entity Type | Organization
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Legal Business Name | DEER RIVER HEALTHCARE CENTER INC
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 115 10TH AVE NE
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City | DEER RIVER
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State | MN
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Zip | 56636-8795
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Country | US
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Telephone | 218-246-3012
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Fax | 218-246-3054
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Provider Business Mailing Address
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Address Line | 115 10TH AVE NE
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City | DEER RIVER
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State | MN
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Zip | 56636-8795
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Country | US
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Telephone | 218-246-3012
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Fax | 218-246-3054
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Authorized Official
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Title or Position | CFO
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Name | KEVIN BOREN
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Credential |
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Telephone | 218-786-1009
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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 | 333483
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License Number State | MN
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