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1457047037
PROVIDENCE HEALTH CARE SERVICES
BLAINE, MN
NPI
1457047037
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Entity Type
Organization
Authorized Contact
TIFFANY JOHNSON
Consultant
763-208-1028
Organization Subpart ?
No
Primary Taxonomy
310400000X Assisted Living Facility
Enumeration Date
2023-04-17
Last Update Date
2023-04-17
Business Address
PROVIDENCE HEALTH CARE SERVICES
781 103RD AVE NE
BLAINE, MN 55434-4507
Phone number: 612-456-2773
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Mailing Address
PROVIDENCE HEALTH CARE SERVICES
781 103RD AVE NE
BLAINE, MN 55434-4507
Phone number: 612-456-2773
Copy
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