Provider Demographics
NPI:1194319558
Name:CEDAR MOUNTAIN HEALTH AND REHAB LLC
Entity type:Organization
Organization Name:CEDAR MOUNTAIN HEALTH AND REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:FACILITY
Authorized Official - Middle Name:
Authorized Official - Last Name:ADMINISTRATOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-557-2211
Mailing Address - Street 1:900 3RD ST S
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:MN
Mailing Address - Zip Code:55333-9799
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:900 3RD ST S
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:MN
Practice Address - Zip Code:55333-9799
Practice Address - Country:US
Practice Address - Phone:507-557-2211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-25
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility