Provider Demographics
NPI:1104815984
Name:MORGAN MEMORIAL FOUNDATION INC
Entity type:Organization
Organization Name:MORGAN MEMORIAL FOUNDATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:D
Authorized Official - Last Name:BROICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-249-3143
Mailing Address - Street 1:96 3RD ST E
Mailing Address - Street 2:
Mailing Address - City:MORGAN
Mailing Address - State:MN
Mailing Address - Zip Code:56266-1414
Mailing Address - Country:US
Mailing Address - Phone:507-249-3143
Mailing Address - Fax:507-249-2310
Practice Address - Street 1:96 3RD ST E
Practice Address - Street 2:
Practice Address - City:MORGAN
Practice Address - State:MN
Practice Address - Zip Code:56266-1414
Practice Address - Country:US
Practice Address - Phone:507-249-3143
Practice Address - Fax:507-249-2310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-14
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN327789314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility