Organization
ITASCA NURSING HOME
Active
Other names
Grand Village
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB GOERING BA, MPH (EXECUTIVE DIRECTOR)
(218) 322-4777
Entity
Organization
Contact information
Practice address
923 HALE LAKE POINTE, GRAND RAPIDS, MN 55744-9615
(218) 326-0543
(218) 327-2405
Mailing address
923 HALE LAKE POINTE, GRAND RAPIDS, MN 55744-9615
(218) 326-0543
(218) 327-2405
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
331920
MN
Other
Enumeration date
06/04/2006
Last updated
08/22/2020
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