Provider Demographics
NPI:1417416504
Name:THE CHESTNUT BURROW
Entity Type:Organization
Organization Name:THE CHESTNUT BURROW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:PAIGE
Authorized Official - Last Name:CALGARO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-410-6218
Mailing Address - Street 1:8643 HIGHWAY 37
Mailing Address - Street 2:
Mailing Address - City:IRON
Mailing Address - State:MN
Mailing Address - Zip Code:55751-8256
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:423 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:VIRGINIA
Practice Address - State:MN
Practice Address - Zip Code:55792-2525
Practice Address - Country:US
Practice Address - Phone:218-410-6218
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-18
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes177F00000XOther Service ProvidersLodging