BIG STONE COMMUNITY HOMES, INC.
Intermediate Care Facility, Mentally Retarded
Ortonville, Minnesota
Provider NPI: 1770676637
Organization Information:Organization Name: BIG STONE COMMUNITY HOMES, INC.
Practice Location:
501 BURDICK AVE ORTONVILLE, MN 56278 US
Tel: 320-839-6139 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
501 BURDICK AVE ORTONVILLE, MN 56278 US
Tel: 320-839-6139 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 315P00000X | Nursing & Custodial Care Facilities Intermediate Care Facility, Mentally Retarded | MN | 801570-1-RS |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
STATE ID # | 4498476 | MN | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin