Provider Demographics
NPI:1457705980
Name:GENTLE TOUCH HEALTH INITIATIVES, LLC
Entity Type:Organization
Organization Name:GENTLE TOUCH HEALTH INITIATIVES, LLC
Other - Org Name:GENTLE TOUCH HEALTH INITIATIVES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:B
Authorized Official - Last Name:PAGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-377-1800
Mailing Address - Street 1:105 PLUM RUN
Mailing Address - Street 2:
Mailing Address - City:LE SUEUR
Mailing Address - State:MN
Mailing Address - Zip Code:56058-2188
Mailing Address - Country:US
Mailing Address - Phone:507-665-2499
Mailing Address - Fax:507-540-1062
Practice Address - Street 1:105 PLUM RUN
Practice Address - Street 2:
Practice Address - City:LE SUEUR
Practice Address - State:MN
Practice Address - Zip Code:56058-2188
Practice Address - Country:US
Practice Address - Phone:507-665-2499
Practice Address - Fax:507-540-1062
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GREAT LAKES MANAGEMENT COMPANY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-04-21
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN375259251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health