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General NPI Number Information
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NPI Number | 1932203320
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Entity Type | Organization
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Legal Business Name | CITY OF CLARA CITY
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Dates
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Enumeration Date | 09/07/2006
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Last Update Date | 09/19/2024
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Provider Practice Location Address
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Address Line | 1012 DIVISION STREET NORTH
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City | CLARA CITY
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State | MN
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Zip | 56222-0797
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Country | US
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Telephone | 320-847-2221
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Fax | 320-847-3553
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Provider Business Mailing Address
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Address Line | 1012 DIVISION ST N
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City | CLARA CITY
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State | MN
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Zip | 56222-1141
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Country | US
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Telephone | 320-847-7216
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Fax | 320-847-3553
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MATTHEW N BLUM
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Credential |
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Telephone | 320-847-7216
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 335473
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License Number State | MN
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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 | 352428
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License Number State | MN
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