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General NPI Number Information
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NPI Number | 1942233234
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Entity Type | Organization
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Legal Business Name | MAHNOMEN HEALTH CENTER
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 08/31/2023
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Provider Practice Location Address
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Address Line | 414 W JEFFERSON AVE
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City | MAHNOMEN
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State | MN
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Zip | 56557-4912
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Country | US
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Telephone | 218-935-2511
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Fax | 218-935-2370
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Provider Business Mailing Address
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Address Line | 414 W JEFFERSON AVE
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City | MAHNOMEN
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State | MN
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Zip | 56557-4912
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Country | US
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Telephone | 218-935-2511
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Fax | 218-935-2370
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Authorized Official
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Title or Position | CFO
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Name | LORI GUENTHER
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Credential |
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Telephone | 218-935-9401
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | 365335
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License Number State | MN
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