1619102092 NPI number — GOLDEN HORIZON ASSISTED, INC.

Table of content: DR. CHRISTINA MARIE HANIGAN DDS (NPI 1073523437)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619102092 NPI number — GOLDEN HORIZON ASSISTED, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GOLDEN HORIZON ASSISTED, 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:
1619102092
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/01/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2025 NICOLLET AVE S #203
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MINNEAPOLIS
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55404
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
612-872-6707
Provider Business Mailing Address Fax Number:
612-872-0728

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1305 8TH ST SW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PINE CITY
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55063-2003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
320-629-7272
Provider Business Practice Location Address Fax Number:
320-629-5388
Provider Enumeration Date:
05/28/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
DRYDEN
Authorized Official First Name:
BETH
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
612-872-6707

Provider Taxonomy Codes

  • Taxonomy code: 310400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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