Provider Demographics
NPI:1629415849
Name:FALLS DELIVERED MEALS
Entity Type:Organization
Organization Name:FALLS DELIVERED MEALS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WINTON
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:FORSBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-681-2311
Mailing Address - Street 1:416 MAPLE AVE S
Mailing Address - Street 2:
Mailing Address - City:THIEF RIVER FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56701-3227
Mailing Address - Country:US
Mailing Address - Phone:218-681-2311
Mailing Address - Fax:
Practice Address - Street 1:309 CHALLENGER DR E
Practice Address - Street 2:
Practice Address - City:THIEF RIVER FALLS
Practice Address - State:MN
Practice Address - Zip Code:56701-4602
Practice Address - Country:US
Practice Address - Phone:218-681-6861
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-29
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care