Provider Demographics
NPI:1629612536
Name:MORA HOUSING AND REDEVELOPMENT AUTHORITY
Entity Type:Organization
Organization Name:MORA HOUSING AND REDEVELOPMENT AUTHORITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REVENUE CYCLE
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:PADGETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-827-8357
Mailing Address - Street 1:170 VALHALLA CIR
Mailing Address - Street 2:
Mailing Address - City:MORA
Mailing Address - State:MN
Mailing Address - Zip Code:55051-4905
Mailing Address - Country:US
Mailing Address - Phone:612-827-8357
Mailing Address - Fax:
Practice Address - Street 1:170 VALHALLA CIR
Practice Address - Street 2:
Practice Address - City:MORA
Practice Address - State:MN
Practice Address - Zip Code:55051-4905
Practice Address - Country:US
Practice Address - Phone:612-827-8357
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-04
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility