Organization · NPI-2

Fairhavens Home Care

Skilled Nursing Facility, Nursing Care, Pediatric · Brooklyn Park, MN

NPI number1275944936
StatusActive
Last updated in NPPESMay 15, 2014

Details

NPI
1275944936
Entity type
Organization (NPI-2)
Legal business name
Fairhavens Home Care
Organization subpart
No
Enumeration date
May 15, 2014
Last updated
May 15, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric366358MNYes

Practice location

2608 87th Trl N
Brooklyn Park, MN 55443-3742

Phone 763-222-4747

Mailing address

2608 87th Trl N
Brooklyn Park, MN 55443-3742

Phone 763-222-4747

Authorized official

Patience Chizoba Okafor
Administrator
7632224747

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