Provider Demographics
NPI:1033260369
Name:CFHGROUP
Entity Type:Organization
Organization Name:CFHGROUP
Other - Org Name:CARDENAS FRIENDSHIP HOMES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:ROY
Authorized Official - Last Name:CARDENAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-670-1380
Mailing Address - Street 1:17595 260TH ST
Mailing Address - Street 2:
Mailing Address - City:SHAFER
Mailing Address - State:MN
Mailing Address - Zip Code:55074-9629
Mailing Address - Country:US
Mailing Address - Phone:612-257-8146
Mailing Address - Fax:651-257-9245
Practice Address - Street 1:912 KNOB HILL RD
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-4325
Practice Address - Country:US
Practice Address - Phone:952-889-8056
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-15
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN4989255OtherMEDICA BILLING NUMBER
MN117075OtherHEATH PARTNERS BILLING