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Organization

MARY T HOSPICE

Active
Parent organization
MARY T. ASSOCIATES
Organization subpart
Yes

Provider details

NPI number
Legal business name
MARY T. ASSOCIATES
Authorized official
MS. MARY T TJOSVOLD (PRESIDENT AND STOCKHOLDER)
(763) 754-2505
Entity
Organization

Contact information

Practice address
1555 118TH LN NW, COON RAPIDS, MN 55448-7579
(763) 754-2505
(763) 862-5472
Mailing address
1555 118TH LN NW, COON RAPIDS, MN 55448-7579
(763) 754-2505
(763) 755-3631

Taxonomy

Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
342612
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
342612
HOSPICE, STATE LICENSE
MN
Enumeration date
12/23/2008
Last updated
12/23/2008
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