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General NPI Number Information
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NPI Number | 1467745273
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Entity Type | Organization
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Legal Business Name | COKATO CHARITABLE TRUST
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Dates
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Enumeration Date | 05/26/2011
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Last Update Date | 05/26/2011
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Provider Practice Location Address
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Address Line | 600 3RD ST SE
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City | COKATO
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State | MN
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Zip | 55321-9402
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Country | US
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Telephone | 320-286-2159
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Fax | 320-286-5729
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Provider Business Mailing Address
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Address Line | 600 3RD ST SE
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City | COKATO
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State | MN
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Zip | 55321-9402
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Country | US
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Telephone | 320-286-2159
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Fax | 320-286-5729
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Authorized Official
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Title or Position | CEO ADMINISTRATOR
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Name | NANCY R STRATMAN
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Credential |
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Telephone | 320-286-3103
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | HFID20523
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License Number State | MN
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