CCN: 248151 NPI: 1942756556 Organization

BETHANY BOARD AND LODGE

903 HILLIGOSS BLVD SE SUITE B
FOSSTON, MN 56542

Contact Information

Phone 2184351044
Fax 2184351143
Enumeration Date 2016-09-01
Last Updated 2019-02-11

Taxonomies

Code: 310400000X
Code: 251E00000X (Primary)

Inpatient Payment Attributes (IPSF) View Dictionary →

Effective Date:

censusDivision 4

cbsaActualGeographicLocation 24220

providerType 36

Outpatient Payment Attributes (OPSF) View Dictionary →

Effective Date:

cbsaActualGeographicLocation 24220

providerType 36

specialPaymentIndicator

carrierCode 06202

localityCode 00