Provider Demographics
NPI:1790788891
Name:HOUSING & REDEVELOPMENT AUTHORITY OF MORRIS
Entity Type:Organization
Organization Name:HOUSING & REDEVELOPMENT AUTHORITY OF MORRIS
Other - Org Name:GRANDVIEW ASSISTED LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:FOHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-589-3142
Mailing Address - Street 1:100 S COLUMBIA AVE
Mailing Address - Street 2:
Mailing Address - City:MORRIS
Mailing Address - State:MN
Mailing Address - Zip Code:56267-1540
Mailing Address - Country:US
Mailing Address - Phone:320-589-3142
Mailing Address - Fax:320-589-3008
Practice Address - Street 1:100 S COLUMBIA AVE
Practice Address - Street 2:
Practice Address - City:MORRIS
Practice Address - State:MN
Practice Address - Zip Code:56267-1540
Practice Address - Country:US
Practice Address - Phone:320-589-3142
Practice Address - Fax:320-589-3008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health