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General NPI Number Information
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NPI Number | 1942203864
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Entity Type | Organization
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Legal Business Name | PENNINGTON & RED LAKE COUNTY PUBLIC HEALTH & HOME CARE
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Dates
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Enumeration Date | 05/24/2005
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 101 MAIN AVE N
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City | THIEF RIVER FALLS
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State | MN
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Zip | 56701-1901
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Country | US
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Telephone | 218-681-0876
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Fax | 218-683-7099
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Provider Business Mailing Address
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Address Line | 101 MAIN AVE N
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City | THIEF RIVER FALLS
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State | MN
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Zip | 56701-1901
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Country | US
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Telephone | 218-681-0876
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Fax | 218-683-7099
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Authorized Official
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Title or Position | DIRECTOR
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Name | KAYLA R JORE
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Credential | PHN
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Telephone | 218-681-0876
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare 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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 326512
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License Number State | MN
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