Organization
GRAND ITASCA CLINIC AND HOSPITAL
Active
Parent organization
GRAND ITASCA CLINIC AND HOSPITAL
Other names
Grand Itasca Home Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
GRAND ITASCA CLINIC AND HOSPITAL
Authorized official
JEAN MACDONELL (COO)
(218) 999-1510
Entity
Organization
Contact information
Practice address
111 SE 3RD ST, GRAND RAPIDS, MN 55744-3663
(218) 999-1055
(218) 999-1052
Mailing address
1601 GOLF COURSE RD, GRAND RAPIDS, MN 55744-8648
(218) 999-1055
(218) 999-1052
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
247286
HUMANA GOLD CHOICE
MN
01
—
59-00055
MEDICA
MN
01
—
5B36AIT
BCBS
MN
01
—
885525100
IMCARE
MN
05
—
885525100
—
MN
Enumeration date
11/17/2006
Last updated
07/23/2025
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