Organization
GREEN PINE ACRES
Active
Other names
MENAHGA HOME HEALTH
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CLAIR E ERICKSON (ADMINISTRATOR)
(218) 564-4101
Entity
Organization
Contact information
Practice address
427 MAIN ST NE, MENAHGA, MN 56464-8702
(218) 564-4101
(218) 564-5309
Mailing address
427 MAIN ST NE, MENAHGA, MN 56464-8702
(218) 564-4101
(218) 564-5309
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
331360
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4980316
MEDICA
FM
05
—
812524400
—
MN
Enumeration date
12/18/2006
Last updated
06/20/2008
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