NPI 1194901751

Henry Hagen Residence

Organisation Intellectual Disabilities Intermediate Care Facility Hastings, MN

Practice location

Address: 19845 Lillehei Ave, Hastings, MN 55033-9354
Phone: (651) 437-9363
Fax: (651) 437-9363

Authorised official

Name: Roger David Reynolds
Title: Owner
Phone: (651) 603-8881

Registered specialties

Intellectual Disabilities Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 315P00000X Licence 01091 (MN)

Other Intermediate Care Facility, Intellectual Disabilities providers in Minnesota →

Registry record

NPI: 1194901751
Entity type: Organization
NPI issued: 14 Jan 2008
Record last updated: 14 Jan 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.