Organization
CENTRAL TODD COUNTY CARE CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON E POLOVICK LNHA (NURSING HOME ADMINISTRATOR)
(218) 756-3636
Entity
Organization
Contact information
Practice address
406 HIGHWAY 71 E, CLARISSA, MN 56440-2000
(218) 756-3636
(218) 756-2276
Mailing address
PO BOX 38, 406 EAST HIGHWAY 71, CLARISSA, MN 56440-0038
(218) 756-3636
(218) 756-2276
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
329956
MN
314000000X
Skilled Nursing Facility
Primary
328579
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
785540100
—
MN
Enumeration date
11/21/2005
Last updated
01/20/2011
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