Divine House II Inc.
Organization Active NPI Intellectual Disabilities Intermediate Care Facility · Dawson, MN
NPI 1770623217 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1770623217
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Intellectual Disabilities Intermediate Care Facility 315P00000X
- Legal business name
- DIVINE HOUSE II INC.
- Practice address
- 2974 192ND St
Dawson, MN 56232 - Phone
- (320) 769-4444
- NPI assigned
- Feb 7, 2007
- Organization subpart
- No
Authorized official
- Name
- Todd Hillstrom
- Title
- Administrator
- Phone
- (320) 769-4444
Corporate family (same tax ID) 1
National Provider Directory
- Tax ID family
- Divine House II Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | MN | Yes |
Addresses
Primary practice location
2974 192ND St
Dawson, MN 56232
Mailing address
2974 192ND St
PO Box 309
Dawson, MN 56232
Phone (320) 769-4444
Other providers in Dawson, MN
- Utpal U Chakravorty
- Jill Jocelyn Christie
- Erica Clark
- Dawson Drug PLLC
- Dawson Drug PLLC
- Krystle Marie Drietz
- Renae A Durfee
- Facing New Horizons, Inc.
- Larry Jay Grong
- Thomas Walter Hansen
All providers in Dawson, MN · Intellectual Disabilities Intermediate Care Facility in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. 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.