Organization
COUNTRY MANOR CAMPUS LLC
Active
Parent organization
COUNTRY MANOR CAMPUS LLC
Other names
Country Manor Extended Services - Woodcrest
Organization subpart
Yes
Provider details
NPI number
Legal business name
COUNTRY MANOR CAMPUS LLC
Authorized official
KEVIN HARGUTH (C.F.O.)
(320) 258-8983
Entity
Organization
Contact information
Practice address
1200 LANIGAN WAY SW, SAINT JOSEPH, MN 56374-4732
(320) 253-3343
(320) 240-0244
Mailing address
520 1ST ST NE, SARTELL, MN 56377-1274
(320) 258-8983
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
04/11/2019
Last updated
06/30/2021
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