Organization
DIVINE PROVIDENCE HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY A WILSON (CEO)
(507) 694-1414
Entity
Organization
Contact information
Practice address
312 E GEORGE ST, IVANHOE, MN 56142-9707
(507) 694-1414
Mailing address
312 E GEORGE ST, PO BOX 136, IVANHOE, MN 56142-9707
(507) 694-1414
Taxonomy
Speciality
Code
Description
License number
State
275N00000X
Medicare Defined Swing Bed Hospital Unit
Primary
331042
MN
Other
Enumeration date
07/12/2006
Last updated
08/22/2020
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