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General NPI Number Information
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NPI Number | 1407843691
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Entity Type | Organization
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Legal Business Name | PERHAM HOSPITAL DISTRICT
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Dates
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Enumeration Date | 10/03/2005
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Last Update Date | 01/27/2022
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Provider Practice Location Address
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Address Line | 735 3RD STREET SW
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City | PERHAM
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State | MN
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Zip | 56573-1108
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Country | US
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Telephone | 218-347-1880
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Fax | 218-347-1885
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Provider Business Mailing Address
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Address Line | 735 3RD STREET SW
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City | PERHAM
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State | MN
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Zip | 56573-1108
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Country | US
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Telephone | 218-347-1880
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Fax | 218-347-1885
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Authorized Official
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Title or Position | VP OF FINANCE
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Name | MRS. JUSTINE ANDERSON
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Credential |
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Telephone | 218-347-1306
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care 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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HFID - 03870
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License Number State | MN
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