Provider Demographics
NPI:1053582635
Name:SCHOOL SISTERS OF NOTRE DAME AT CENTRAL PACIFIC PROVINCE, INC
Entity type:Organization
Organization Name:SCHOOL SISTERS OF NOTRE DAME AT CENTRAL PACIFIC PROVINCE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT PROVINCE TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:ROSEMARY
Authorized Official - Middle Name:
Authorized Official - Last Name:SNAZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-389-4214
Mailing Address - Street 1:170 GOOD COUNSEL DRIVE
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-3138
Mailing Address - Country:US
Mailing Address - Phone:507-389-4200
Mailing Address - Fax:507-389-4205
Practice Address - Street 1:170 GOOD COUNSEL DRIVE
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-3138
Practice Address - Country:US
Practice Address - Phone:507-389-4200
Practice Address - Fax:507-389-4205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-21
Last Update Date:2011-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNA690266900Medicaid