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MSOCS-PINE CITY

Intermediate Care Facility, Mentally Retarded

Pine City, Minnesota

Provider NPI: 1750454583

Organization Information:
Organization Name:  MSOCS-PINE CITY


Practice Location:
215 6TH AVE SE  PINE CITY, MN 55063 US
Tel: 320-629-2116  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y315P00000XNursing & Custodial Care Facilities
Intermediate Care Facility, Mentally Retarded

Other Provider Identifiers:

IssuerNumberStateType
823745000MN05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




MENTALLY RETARDED JOBS MN - Page 1



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