Organization Name: | OPEN HARBORS INC. |
NPI Number: | 1346425543 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARGERY ANN VETSCH-PETERSON (PRESIDENT) |
Mailing Address: | 28347 112th St Nw Zimmerman |
State: | MN US |
Postal Code: | 553984307 |
Phone Number: | 7633895412 |
Fax Number: | |
NPI Enumeration Date: | 01/07/2008 |
NPI Last Update Date: | 01/07/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 385H00000X |
License Number: | 10413503AFC |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Respite Care Facility |
Taxonomy Classification: | Respite Care |
Taxonomy Specialization: | |
Taxonomy Definition: |