Organization
SKILLS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBRA KAY THOMAS RN, QMRP (CEO)
(218) 477-1919
Entity
Organization
Contact information
Practice address
810 4TH AVE S, SUITE 100, MOORHEAD, MN 56560-2800
(218) 477-1919
Mailing address
810 4TH AVE S, SUITE 100, MOORHEAD, MN 56560-2800
(218) 477-1919
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1062246
MN EIN
MN
Enumeration date
01/10/2007
Last updated
08/22/2020
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