Provider Demographics
NPI:1053318303
Name:NORTHWEST HEALTH CARE, INC
Entity Type:Organization
Organization Name:NORTHWEST HEALTH CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DARWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWANTES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-251-9120
Mailing Address - Street 1:1717 UNIVERSITY DR SE
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56304-2023
Mailing Address - Country:US
Mailing Address - Phone:320-251-9120
Mailing Address - Fax:320-251-4336
Practice Address - Street 1:1717 UNIVERSITY DR SE
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56304-2023
Practice Address - Country:US
Practice Address - Phone:320-251-9120
Practice Address - Fax:320-251-4336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-01
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN325511314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN8752CLOtherBCBS
MN71-22554OtherMEDICA
MN241543700Medicaid
MNNH0156OtherUCARE
MN0919730001Medicare NSC
MN71-22554OtherMEDICA