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General NPI Number Information
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NPI Number | 1770718926
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Entity Type | Organization
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Legal Business Name | RANGE DEVELOPMENT COMPANY
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Dates
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Enumeration Date | 05/18/2009
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Last Update Date | 05/18/2009
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Provider Practice Location Address
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Address Line | 2229 3RD AVE E
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City | HIBBING
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State | MN
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Zip | 55746-1911
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Country | US
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Telephone | 218-263-4157
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Fax | 218-263-8534
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Provider Business Mailing Address
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Address Line | 2229 3RD AVE E P.O. BOX 786
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City | HIBBING
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State | MN
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Zip | 55746-1911
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Country | US
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Telephone | 218-263-4157
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Fax | 218-263-8534
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. RANDY P SCHROETTER
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Credential |
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Telephone | 218-263-4157
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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 | 340137
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 34092
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License Number State | MN
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