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General NPI Number Information
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NPI Number | 1336359900
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Entity Type | Organization
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Legal Business Name | PRESBYTERIAN FAMILY FOUNDATION
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 06/12/2008
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Provider Practice Location Address
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Address Line | 110 5TH ST N
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City | ATWATER
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State | MN
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Zip | 56209
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Country | US
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Telephone | 320-974-8070
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Fax |
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Provider Business Mailing Address
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Address Line | 901 HIGHWAY 71 NE
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City | WILLMAR
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State | MN
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Zip | 56201-2654
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Country | US
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Telephone | 320-235-5897
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | CATHERINE JOHNSON
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Credential |
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Telephone | 320-235-5897
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number |
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License Number State |
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