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Organization

NORTHEAST RESIDENCE, INC.

Active
Other names
Northeast Residence, Inc. Respite
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. CORRINE MAE SCHMIDT (ADMINISTRATOR)
(651) 765-0217
Entity
Organization

Contact information

Practice address
410 LITTLE CANADA RD E, LITTLE CANADA, MN 55117-1629
(651) 765-0217
(651) 765-0212
Mailing address
410 LITTLE CANADA RD E, LITTLE CANADA, MN 55117-1629
(651) 765-0217
(651) 765-0212

Taxonomy

Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
801750
MN

Other

Enumeration date
02/20/2007
Last updated
08/22/2020
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