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Organization
GRAND ITASCA CLINIC AND HOSPITAL
Active
Organization
GRAND ITASCA CLINIC AND HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TODD CHRISTENSEN (VP OF FINANCE)
(218) 999-1702
Entity
Organization
Contact information
Practice address
1601 GOLF COURSE RD, GRAND RAPIDS, MN 55744-8648
(218) 326-3401
(218) 999-1461
Mailing address
1700 UNIVERSITY AVE W, SAINT PAUL, MN 55104-3727
(612) 672-6740
(612) 884-3592
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
NULL
273Y00000X
Rehabilitation Hospital Unit
—
MN
275N00000X
Medicare Defined Swing Bed Hospital Unit
—
NULL
282N00000X
General Acute Care Hospital
Primary
330789
MN
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
Other
Enumeration date
05/22/2006
Last updated
02/14/2025
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