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Organization

DIVINE PROVIDENCE COMMUNITY HOME

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. JAYNA MARIE GROEBNER LNHA (ADMINISTRATOR)
(507) 794-3011
Entity
Organization

Contact information

Practice address
700 THIRD AVE NW, SLEEPY EYE, MN 56085
(507) 794-3011
(507) 794-3020
Mailing address
700 THIRD AVE NW, SLEEPY EYE, MN 56085
(507) 794-3011
(507) 794-3020

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
328233
MN
314000000X
Skilled Nursing Facility
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
356540800
MN
Enumeration date
09/22/2005
Last updated
01/12/2012
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