Organization Name: | EAGLE'S CROSSING ADULT DAY CENTER (MORA EAGLET) |
NPI Number: | 1053687533 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DIANE KAY KRAMER (OWNER/ ADULT DAY DIRECTOR) |
Mailing Address: | 133 Union St S Ste 4 Mora |
State: | MN US |
Postal Code: | 550511579 |
Phone Number: | 3202853128 |
Fax Number: | |
NPI Enumeration Date: | 03/28/2012 |
NPI Last Update Date: | 03/28/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QA0600X |
License Number: | 1062197 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Adult Day Care |
Taxonomy Definition: |