Provider Demographics
NPI:1477974434
Name:AUGUSTANA COMMUNITY PARTNERS
Entity Type:Organization
Organization Name:AUGUSTANA COMMUNITY PARTNERS
Other - Org Name:THOMAS T. FEENEY MANOR
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:KITTELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-238-5205
Mailing Address - Street 1:901 4TH AVE N
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55405-1188
Mailing Address - Country:US
Mailing Address - Phone:612-843-0090
Mailing Address - Fax:612-377-3098
Practice Address - Street 1:901 4TH AVE N
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55405-1188
Practice Address - Country:US
Practice Address - Phone:612-843-0090
Practice Address - Fax:612-377-3098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-18
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN361970310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility