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General NPI Number Information
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NPI Number | 1609011170
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Entity Type | Organization
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Legal Business Name | ST. FRANCIS HEALTH CARE SYSTEM INC
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Dates
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Enumeration Date | 12/11/2008
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Last Update Date | 12/11/2008
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Provider Practice Location Address
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Address Line | 1591 WOODLYNN AVE UNIT 1
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City | MAPLEWOOD
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State | MN
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Zip | 55109-5709
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Country | US
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Telephone | 612-309-8391
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Fax |
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Provider Business Mailing Address
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Address Line | 1591 WOODLYNN AVE UNIT 1
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City | MAPLEWOOD
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State | MN
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Zip | 55109-5709
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Country | US
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Telephone | 612-309-8391
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. KENETH NUBIA
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Credential |
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Telephone | 612-309-8391
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 340276
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License Number State | MN
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