Organization · Type 2 NPI

Providence Health Care Services

Assisted Living Facility · Blaine, MN

NPI number 1457047037 Active

Practice location

781 103rd Ave NE
Blaine, MN 55434-4507

Call (612) 456-2773 Map

Fax (763) 374-4469

Other practice locations

  • 15236 Germanium Cir NW, Ramsey, MN 55303-5163 · (763) 444-1811

Specialties and licenses

TaxonomyCodeLicense
Assisted Living Facility Primary 310400000XNone listed

Assisted Living Facility: A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

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About NPI 1457047037

Providence Health Care Services's National Provider Identifier is 1457047037, issued on Apr 17, 2023. The primary taxonomy on file is Assisted Living Facility (310400000X), and the practice location is in Blaine, MN. The record was last updated on May 30, 2025.