Provider Demographics
NPI: | 1093985319 |
---|---|
Name: | UNITY FAMILY HEALTHCARE |
Entity Type: | Organization |
Organization Name: | UNITY FAMILY HEALTHCARE |
Other - Org Name: | LITTLE FALLS ORTHOPEDICS |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | CLINIC ADMINISTER |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | JIM |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | MUSTONEN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 320-632-3671 |
Mailing Address - Street 1: | 1108 1ST ST SE |
Mailing Address - Street 2: | |
Mailing Address - City: | LITTLE FALLS |
Mailing Address - State: | MN |
Mailing Address - Zip Code: | 56345-3440 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 320-632-3671 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1108 1ST ST SE |
Practice Address - Street 2: | |
Practice Address - City: | LITTLE FALLS |
Practice Address - State: | MN |
Practice Address - Zip Code: | 56345-3440 |
Practice Address - Country: | US |
Practice Address - Phone: | 320-632-3671 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2008-03-03 |
Last Update Date: | 2008-03-03 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
MN | 339096 | 282NC0060X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 282NC0060X | Hospitals | General Acute Care Hospital | Critical Access |