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General NPI Number Information
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NPI Number | 1902917651
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Entity Type | Organization
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Legal Business Name | RENVILLE COUNTY
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 06/18/2019
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Provider Practice Location Address
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Address Line | 105 S 5TH ST SUITE 119H
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City | OLIVIA
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State | MN
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Zip | 56277-1375
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Country | US
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Telephone | 320-523-2570
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Fax | 320-523-3749
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Provider Business Mailing Address
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Address Line | 105 S 5TH ST SUITE 119H
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City | OLIVIA
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State | MN
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Zip | 56277-1375
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Country | US
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Telephone | 320-523-2570
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Fax | 320-523-3749
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. JILL L BRUNS
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Credential | RN, PHN
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Telephone | 320-523-3723
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | 331319
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License Number State | MN
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