Organization
ST. CLOUD HOSPITAL
Active
Other names
CentraCare Home Health
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL A. BLAIR (SR. VICE PRESIDENT AND CFO)
(320) 255-5665
Entity
Organization
Contact information
Practice address
110 2ND ST S STE 104, WAITE PARK, MN 56387-1367
(320) 251-2700
(320) 656-7009
Mailing address
1406 6TH AVE NORTH, SAINT CLOUD, MN 56303-1900
(320) 251-2700
(320) 656-7009
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
331506
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
531355400
—
MN
Enumeration date
05/09/2006
Last updated
10/09/2020
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