MEDICARE: MN HEALTHCARE INC

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
1	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1871035204
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MN HEALTHCARE INC

Provider Business Mailing Address
First Line	:	5775 WAYZATA BLVD
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55416-1222
Country	:	US
Telephone Number	:	612-405-6343
Fax Number	:

Provider Business Practice Location Address
First Line	:	5775 WAYZATA BLVD
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55416-1222
Country	:	US
Telephone Number	:	612-405-6343
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MICHAEL CROW
Credential	:
Telephone Number	:	612-405-6343

Provider Enumeration Date	:	11/16/2016
Last Update Date	:	11/16/2016

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