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Organization

ESSENTIA HEALTH MOOSE LAKE

Active
Parent organization
ESSENTIA HEALTH
Other names
Essentia Health Moose Lake (Swing Bed)
Organization subpart
Yes

Provider details

NPI number
Legal business name
ESSENTIA HEALTH
Authorized official
KEVIN BOREN (VP OF FINANCE)
(218) 786-1009
Entity
Organization

Contact information

Practice address
4572 COUNTY ROAD 61, MOOSE LAKE, MN 55767-9401
(218) 485-4481
Mailing address
4572 COUNTY ROAD 61, MOOSE LAKE, MN 55767-9401
(218) 485-4481

Taxonomy

Speciality
Code
Description
License number
State
275N00000X
Medicare Defined Swing Bed Hospital Unit
Primary

Other

Enumeration date
04/07/2020
Last updated
02/27/2026
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