Itasca Nursing Home
NPI #1184662793 in Grand Rapids, Minnesota
Provider Information
- NPI Number
- 1184662793
- Entity Type
- Organization
- Organization Name
- Itasca Nursing Home
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Jun 4, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 923 HALE LAKE POINTE
- City
- Grand Rapids
- State
- Minnesota
- ZIP Code
- 55744-9615
- Phone
- (218) 326-0543
Authorized Official
- Name
- JACOB GOERING, BA, MPH
- Title
- EXECUTIVE DIRECTOR
- Phone
- (218) 322-4777
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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