Organization
SERVANTS OF RELIEF FOR INCURABLE CANCER
Active
Other names
Our Lady of Good Counsel Home
Organization subpart
No
Provider details
NPI number
Authorized official
CLAIRE THERESE NADEAU (ADMINISTRATOR)
(651) 646-2797
Entity
Organization
Contact information
Practice address
2076 ST ANTHONY AVENUE, ST PAUL, MN 55104-5028
(651) 646-2797
(651) 646-7884
Mailing address
2076 ST ANTHONY AVENUE, ST PAUL, MN 55104-5028
(651) 646-2797
(651) 646-7884
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
02827ADMINISTRATOR
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
869
NH FACILITY
MN
Enumeration date
05/15/2007
Last updated
08/22/2020
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