1891851507 NPI number — RIVERBLUFF HEALTH CARE, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891851507 NPI number — RIVERBLUFF HEALTH CARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RIVERBLUFF HEALTH CARE, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1891851507
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/13/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
48329 239TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW ULM
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
56073-5257
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
507-947-3825
Provider Business Mailing Address Fax Number:
507-947-3461

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
48329 239TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW ULM
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56073-5257
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
507-947-3825
Provider Business Practice Location Address Fax Number:
507-947-3461
Provider Enumeration Date:
12/28/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
STRENGE
Authorized Official First Name:
CAROL
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER, SECRETARY TREASURER
Authorized Official Telephone Number:
507-947-3825

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  3894 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)