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General NPI Number Information
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NPI Number | 1891755849
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Entity Type | Organization
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Legal Business Name | BENEDICTINE HEALTH CENTER
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Dates
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Enumeration Date | 03/24/2006
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Last Update Date | 04/28/2023
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Provider Practice Location 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 | 218-723-6408
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Fax | 218-723-6449
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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 | 218-723-6408
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Fax | 218-723-6449
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Authorized Official
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Title or Position | BUSINESS OFFICE MANAGER
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Name | MS. JULIE TOMAINO
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Credential |
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Telephone | 218-723-6430
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 329925
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License Number State | MN
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