Organization
NORTHOME HEALTHCARE CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HOWIE GROFF (PRESIDENT)
(952) 888-2923
Entity
Organization
Contact information
Practice address
11995 MAIN ST, NORTHOME, MN 56661-8077
(218) 897-5235
Mailing address
11995 MAIN ST, PO BOX 138, NORTHOME, MN 56661-8077
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
330574
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1186792AFC
ADULT FOSTER CARE
MN
05
—
322518600
—
MN
01
—
366017600
ITASCA
MN
05
—
430068800
—
MN
01
—
8055962WS
SLS WAIVERED
MN
01
—
9788NO
BCBS
MN
Enumeration date
04/27/2006
Last updated
10/15/2008
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