Community Memorial Hospital Association

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

MN331132 Issued in MN

Legal business name

COMMUNITY MEMORIAL HOSPITAL ASSOCIATION

Practice address

512 Skyline Blvd
Cloquet, MN 55720-3787

Phone

(218) 879-4641

Fax

(218) 879-3237

NPI assigned

Jun 1, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Richard L. Breuer

Title

Ceo/Administrator

Phone

(218) 878-7621

Specialties & licenses 1

Addresses

Other names 1

• SUNNYSIDE HEALTHCARE CENTER Other name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188950400000",
    "number": "1710924428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 SKYLINE BLVD",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557203787",
            "telephone_number": "218-879-4641",
            "fax_number": "218-879-3237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 SKYLINE BLVD",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557203787",
            "telephone_number": "218-879-4641",
            "fax_number": "218-879-3237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY MEMORIAL HOSPITAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2007-09-05",
        "status": "A",
        "authorized_official_last_name": "BREUER",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "CEO/ADMINISTRATOR",
        "authorized_official_telephone_number": "218-878-7621",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MN",
            "license": "MN331132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SUNNYSIDE HEALTHCARE CENTER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Nicole Collins, LICSW
• Richard Lee Colsen
• Community Memorial Hospital Association
• Community Memorial Hospital Association
• Community Memorial Hospital Association
• Compass Rose Counseling and Wellness, LLC
• Compassionate Quality Psychiatry PLLC
• Holly Jo Compo, RN, PHN
• John L Connolly, DDS
• Lindsey Ann Cook

• Skilled Nursing Facility in Cloquet, MN
• Providers in Cloquet, MN by specialty
• Skilled Nursing Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.