Organization
ST MARYS REGIONAL HEALTH CENTER
Active
Parent organization
ESSENTIA HEALTH
Other names
Essentia Health Home Care West
Organization subpart
Yes
Provider details
NPI number
Legal business name
ESSENTIA HEALTH
Authorized official
ALAN JAMES HURLEY (COO)
(979) 820-4247
Entity
Organization
Contact information
Practice address
114 FRAZEE ST E, DETROIT LAKES, MN 56501
(218) 847-0808
(218) 847-0850
Mailing address
114 FRAZEE ST E, DETROIT LAKES, MN 56501-3502
(218) 847-0808
(218) 847-0850
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
—
—
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
892442000
—
MN
Enumeration date
10/24/2005
Last updated
03/01/2024
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