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General NPI Number Information
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NPI Number | 1881767069
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Entity Type | Organization
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Legal Business Name | SPECTRUM COMMUNITY HEALTH, INC.
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 418 9TH ST S
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City | VIRGINIA
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State | MN
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Zip | 55792-2838
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Country | US
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Telephone | 218-741-3013
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Fax |
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Provider Business Mailing Address
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Address Line | 850 2ND ST NW
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City | AITKIN
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State | MN
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Zip | 56431-1140
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Country | US
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Telephone | 218-260-2301
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT OF OPERATIONS
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Name | HEATHER POTTER
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Credential |
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Telephone | 218-927-2164
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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 | 313695
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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 | 334658
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License Number State | MN
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