Provider Demographics
NPI:1285657247
Name:NORTH MEMORIAL HEALTH CARE
Entity Type:Organization
Organization Name:NORTH MEMORIAL HEALTH CARE
Other - Org Name:NORTH MEMORIAL HEALTH REHABILITATION THERAPY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-581-4768
Mailing Address - Street 1:PO BOX 735463
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-5463
Mailing Address - Country:US
Mailing Address - Phone:763-581-3440
Mailing Address - Fax:763-581-3441
Practice Address - Street 1:3300 OAKDALE AVE N
Practice Address - Street 2:
Practice Address - City:ROBBINSDALE
Practice Address - State:MN
Practice Address - Zip Code:55422-2926
Practice Address - Country:US
Practice Address - Phone:763-581-3440
Practice Address - Fax:763-581-3441
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTH MEMORIAL HEALTHCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-25
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN777545801Medicaid
MN777545801Medicaid