Organization Name: | GRACEVILLE HEALTH CENTER |
NPI Number: | 1013976281 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KIM BODENSTEINER (CFO) |
Mailing Address: | 115 W 2nd St Graceville |
State: | MN US |
Postal Code: | 562404803 |
Phone Number: | 3207487243 |
Fax Number: | 3207488204 |
NPI Enumeration Date: | 03/17/2006 |
NPI Last Update Date: | 02/12/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR1300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rural Health |
Taxonomy Definition: |