Provider Demographics
NPI:1134357569
Name:ROBBINSDALE REHAB AND CARE CTR
Entity type:Organization
Organization Name:ROBBINSDALE REHAB AND CARE CTR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL DIR OF REHAB
Authorized Official - Prefix:
Authorized Official - First Name:LISABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:MACKALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-437-0213
Mailing Address - Street 1:3130 GRIMES AVE N
Mailing Address - Street 2:
Mailing Address - City:ROBBINSDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55422-3217
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3130 GRIMES AVENUE NORTH
Practice Address - Street 2:
Practice Address - City:ROBBINSDALE
Practice Address - State:MN
Practice Address - Zip Code:55422
Practice Address - Country:US
Practice Address - Phone:736-450-2737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-24
Last Update Date:2009-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility