| Organization Name: | KANABEC-PINE COMMUNITY HEALTH |
| NPI Number: | 1619374428 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WENDY L. THOMPSON (CHS ADMINISTRATOR) |
| Mailing Address: | 905 Forest Ave E Suite 127 Mora |
| State: | MN US |
| Postal Code: | 550511624 |
| Phone Number: | 3206796330 |
| Fax Number: | 3206796333 |
| NPI Enumeration Date: | 11/21/2014 |
| NPI Last Update Date: | 11/21/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251K00000X |
| License Number: | 331159 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Public Health or Welfare |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |