Autumn Hills of Bemidji, Inc.
Organization Active NPI Home Health Agency · Bemidji, MN
NPI 1659623536 · NPPES record last updated Oct 3, 2012
Key facts
- NPI
- 1659623536
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- License
- 358062 (MN)
- Legal business name
- AUTUMN HILLS OF BEMIDJI, INC.
- Practice address
- 2528 Park Ave NW
Bemidji, MN 56601-2432 - Phone
- (218) 333-3854
- Fax
- (218) 333-3855
- NPI assigned
- Oct 3, 2012
- Organization subpart
- No
Authorized official
- Name
- Mrs. Shelley Jean Cloose, RN
- Title
- President
- Phone
- (218) 333-3854
Corporate family (same tax ID) 1
National Provider Directory
- Tax ID family
- Autumn Hills Home Care
Locations
2528 Park Ave NW
Bemidji, MN 56601
Phone (218) 333-3854
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 358062 | MN | Yes |
Addresses
Primary practice location
2528 Park Ave NW
Bemidji, MN 56601-2432
Mailing address
2528 Park Ave NW
Bemidji, MN 56601-2432
Phone (218) 333-3854
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A034943700 | Other | MN | UMPI |
Other names
- Autumn Hills Home Care
Other providers in Bemidji, MN
- Assessment & Counseling Associates LLC
- Associated Drug Inc
- Jonas Attilus
- Aurora Waasakone Community of Learners
- Autumn Hills of Bemidji, Inc.
- Kimberly Jean Sletta Avenson
- Ethan Axtman
- Tiffany Alicia Axtman
- Alexandra Patricia Bader
- Sanggyu Bae
All providers in Bemidji, MN · Home Health Agency in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 3, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.