Provider Demographics
NPI:1114094620
Name:HEALTHPARTNERS RC
Entity Type:Organization
Organization Name:HEALTHPARTNERS RC
Other - Org Name:RENVILLE COUNTY HOSPICE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BLAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-523-3575
Mailing Address - Street 1:100 HEALTHY WAY
Mailing Address - Street 2:
Mailing Address - City:OLIVIA
Mailing Address - State:MN
Mailing Address - Zip Code:56277-1117
Mailing Address - Country:US
Mailing Address - Phone:320-523-1261
Mailing Address - Fax:320-523-8349
Practice Address - Street 1:100 HEALTHY WAY
Practice Address - Street 2:
Practice Address - City:OLIVIA
Practice Address - State:MN
Practice Address - Zip Code:56277-1117
Practice Address - Country:US
Practice Address - Phone:320-523-1261
Practice Address - Fax:320-523-3458
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTHPARTNERS RC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-29
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN331046251G00000X, 315D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI304706539Medicaid
TX072262101Medicaid
MN502347500Medicaid
ND2457Medicaid
MI404706548Medicaid
SD5529420Medicaid
OKH4160068805Medicaid
MN268517500Medicaid
WI80617900Medicaid
OKH4160068805Medicaid
241306Medicare Oscar/Certification
TX072262101Medicaid
MN502347500Medicaid