# GRAND ITASCA CLINIC AND HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669426631
- **Authorized official:** TODD CHRISTENSEN (VP OF FINANCE)
- **Authorized official phone:** (218) 999-1702

## Contact information

- **Practice address:** 1601 GOLF COURSE RD, GRAND RAPIDS, MN 55744-8648
- **Practice address phone:** (218) 326-3401
- **Practice address fax:** (218) 999-1461
- **Mailing address:** 1700 UNIVERSITY AVE W, SAINT PAUL, MN 55104-3727
- **Mailing address phone:** (612) 672-6740
- **Mailing address fax:** (612) 884-3592

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | — |
| 273Y00000X | Rehabilitation Hospital Unit | — | MN | — |
| 275N00000X | Medicare Defined Swing Bed Hospital Unit | — | NULL | — |
| 282N00000X | General Acute Care Hospital | 330789 | MN | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |

## Other

- **Enumeration date:** 05/22/2006
- **Last updated:** 02/14/2025