Organization
FOUNDATION FOR RURAL HEALTH CARE
Active
Other names
Evansville Residence
Organization subpart
No
Provider details
NPI number
Authorized official
CORAL BLAZE RN,C RAC-C, CLNC (CEO)
(952) 435-7371
Entity
Organization
Contact information
Practice address
651 STATE ST NW, EVANSVILLE, MN 56326-8183
(218) 948-2346
Mailing address
651 STATE ST NW, EVANSVILLE, MN 56326-8183
(218) 948-2346
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
333275
MN
Other
Enumeration date
09/05/2006
Last updated
08/22/2020
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