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NPI Code Detail

MEDICARE: INTEGRACARE LTD

MEDICARE: INTEGRACARE LTD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist
2111N00000XChiropractor
3207Q00000XFamily Medicine Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CH337OTHERMNRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
331T18INOTHERMNBCBS
470633OTHERMNHEALTH PARTNERS

General Provider Information

NPI Number : 1770646937
Entity Type Code : Organization
Provider Name (Legal Business Name) : INTEGRACARE LTD
Provider Business Mailing Address
First Line : 2251 CONNECTICUT AVE S STE 2100
Second Line :
City : SARTELL
State : MN
Zip : 56377-2486
Country : US
Telephone Number : 320-251-2600
Fax Number : 320-251-4763
Provider Business Practice Location Address
First Line : 2251 CONNECTICUT AVE S STE 2100
Second Line :
City : SARTELL
State : MN
Zip : 56377-2486
Country : US
Telephone Number : 320-251-2600
Fax Number : 320-251-4763
Authorized Official
Title or Position : PRACTICE ADMINISTRATOR
Name : TANNER NEUBAUER
Credential :
Telephone Number : 320-251-2600
Provider Enumeration Date : 12/19/2006
Last Update Date : 03/16/2026

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1720049752 — LESLIE G LOFGREN MD
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Directions to “INTEGRACARE LTD ” Practice Location

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