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Organization

BAKER PARK

Active
Parent organization
SANFORD HEALTH OF NORTHERN MINNESOTA
Organization subpart
Yes

Provider details

NPI number
Legal business name
SANFORD HEALTH OF NORTHERN MINNESOTA
Authorized official
MR. JON F BERGQUIST (BUSINESS OFFICE MANAGER)
(218) 333-5514
Entity
Organization

Contact information

Practice address
1000 ANNE ST NW, BEMIDJI, MN 56601-5109
(218) 751-0220
(218) 333-6514
Mailing address
1300 ANNE ST NW, BEMIDJI, MN 56601-5103
(218) 333-6514
(218) 333-5566

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
349267
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
106240900
MN
Enumeration date
09/30/2011
Last updated
04/23/2013
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