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General NPI Number Information
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NPI Number | 1649400961
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Entity Type | Organization
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Legal Business Name | DW HEARTHSTONE HOLDINGS, LLC
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Dates
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Enumeration Date | 07/21/2009
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Last Update Date | 09/20/2022
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Provider Practice Location Address
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Address Line | 935 N KENWOOD AVENUE
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City | DULUTH
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State | MN
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Zip | 55811
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Country | US
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Telephone | 218-740-4290
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Fax | 218-279-4412
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Provider Business Mailing Address
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Address Line | 935 KENWOOD AVE
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City | DULUTH
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State | MN
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Zip | 55811-4951
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Country | US
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Telephone | 218-740-4290
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Fax | 218-279-4412
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Authorized Official
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Title or Position | COMMUNITY HEALTH DIRECTOR
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Name | MS. AMANDA LAUREL SZUMOWSKI DAHL
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Credential |
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Telephone | 218-625-2307
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 367084
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License Number State | MN
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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 |
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License Number State |
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