Provider Demographics
NPI:1699779009
Name:BARRETT CARE CENTER. INC
Entity type:Organization
Organization Name:BARRETT CARE CENTER. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:VERNON
Authorized Official - Middle Name:
Authorized Official - Last Name:JUNKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-528-2527
Mailing Address - Street 1:800 SPRUCE AVE
Mailing Address - Street 2:
Mailing Address - City:BARRETT
Mailing Address - State:MN
Mailing Address - Zip Code:56311-4505
Mailing Address - Country:US
Mailing Address - Phone:320-528-2527
Mailing Address - Fax:320-528-2642
Practice Address - Street 1:800 SPRUCE AVE
Practice Address - Street 2:
Practice Address - City:BARRETT
Practice Address - State:MN
Practice Address - Zip Code:56311-4505
Practice Address - Country:US
Practice Address - Phone:320-528-2527
Practice Address - Fax:320-528-2642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-13
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN327710314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN879240200Medicaid
MN245575Medicare Oscar/Certification