Organization
MARY T ASSOCIATES INC
Active
Parent organization
MARY T INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MARY T INC
Authorized official
CONNIE WINBAUER (CONTROLLER)
(763) 862-5436
Entity
Organization
Contact information
Practice address
1555 118TH LN NW, COON RAPIDS, MN 55448-7579
(763) 862-5436
(763) 754-0332
Mailing address
1555 118TH LN NW, COON RAPIDS, MN 55448-7579
(763) 862-5436
(763) 754-0332
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
331577
MN
315P00000X
Intellectual Disabilities Intermediate Care Facility
801456
MN
315P00000X
Intellectual Disabilities Intermediate Care Facility
801457
MN
315P00000X
Intellectual Disabilities Intermediate Care Facility
801458
MN
315P00000X
Intellectual Disabilities Intermediate Care Facility
801459
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102207
HEALTH PARTNERS
MN
01
—
104337
U CARE FC
FM
01
—
131415
U CARE HHA
MN
01
—
136968
U CARE PCA
MN
05
—
472845900
—
MN
05
—
612745200
—
MN
05
—
642845200
—
MN
05
—
672745000
—
MN
01
—
9394AB
BCBS
MN
05
—
972525300
—
MN
Enumeration date
12/11/2006
Last updated
02/12/2008
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