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General NPI Number Information
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NPI Number | 1518617927
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Entity Type | Organization
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Legal Business Name | PATRON ADULT FOSTER CARE
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Dates
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Enumeration Date | 03/28/2022
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Last Update Date | 03/28/2022
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Provider Practice Location Address
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Address Line | 6975 SAUKVIEW DR STE 100
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City | SAINT CLOUD
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State | MN
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Zip | 56303-1967
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Country | US
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Telephone | 320-345-5736
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 399
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City | WAITE PARK
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State | MN
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Zip | 56387-0399
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Country | US
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Telephone | 320-345-5736
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | BENJAMIN T WARNE
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Credential |
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Telephone | 320-345-5736
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253J00000X
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Taxonomy Name | Foster Care Agency
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License Number |
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License Number State |
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