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General NPI Number Information
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NPI Number | 1407367030
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Entity Type | Organization
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Legal Business Name | CARRIS HEALTH LLC
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Dates
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Enumeration Date | 10/23/2017
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Last Update Date | 03/03/2025
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Provider Practice Location Address
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Address Line | 301 BECKER AVE SW
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City | WILLMAR
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State | MN
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Zip | 56201-3302
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Country | US
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Telephone | 320-235-4543
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Fax |
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Provider Business Mailing Address
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Address Line | 1406 6TH AVE N
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City | SAINT CLOUD
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State | MN
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Zip | 56303-1900
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Country | US
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Telephone | 320-231-4425
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | MICHAEL BLAIR
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Credential |
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Telephone | 320-255-5665
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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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 | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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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 | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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