Provider Demographics
NPI:1346296696
Name:VILLAGE OF HAYFIELD
Entity Type:Organization
Organization Name:VILLAGE OF HAYFIELD
Other - Org Name:FIELD CREST CARE CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:WILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-477-3266
Mailing Address - Street 1:318 2ND ST NE
Mailing Address - Street 2:
Mailing Address - City:HAYFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55940-8857
Mailing Address - Country:US
Mailing Address - Phone:507-477-3266
Mailing Address - Fax:507-477-3268
Practice Address - Street 1:318 2ND ST NE
Practice Address - Street 2:
Practice Address - City:HAYFIELD
Practice Address - State:MN
Practice Address - Zip Code:55940-8857
Practice Address - Country:US
Practice Address - Phone:507-477-3266
Practice Address - Fax:507-477-3268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2010-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN00104314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN304240500Medicaid
MN8689FIOtherBLUE CROSS BLUE SHIELD
MN304240500Medicaid