Provider Demographics
NPI:1194471466
Name:AITKIN COUNTY CARE, INC.
Entity Type:Organization
Organization Name:AITKIN COUNTY CARE, INC.
Other - Org Name:AITKIN COUNTY CARE, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LYNNE
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-927-1383
Mailing Address - Street 1:PO BOX 212
Mailing Address - Street 2:
Mailing Address - City:AITKIN
Mailing Address - State:MN
Mailing Address - Zip Code:56431-0212
Mailing Address - Country:US
Mailing Address - Phone:218-927-1383
Mailing Address - Fax:218-927-1382
Practice Address - Street 1:20 3RD ST NE
Practice Address - Street 2:
Practice Address - City:AITKIN
Practice Address - State:MN
Practice Address - Zip Code:56431-1422
Practice Address - Country:US
Practice Address - Phone:218-927-1383
Practice Address - Fax:218-927-1382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-25
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNA877435300OtherUMPI