Provider Demographics
NPI:1043665904
Name:GENTLE TOUCH HEALTH INITIATIVES, LLC
Entity type:Organization
Organization Name:GENTLE TOUCH HEALTH INITIATIVES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:B
Authorized Official - Last Name:PAGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-377-1800
Mailing Address - Street 1:10669 ULYSSES ST NE
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:55434-3767
Mailing Address - Country:US
Mailing Address - Phone:763-754-7300
Mailing Address - Fax:763-754-2561
Practice Address - Street 1:10669 ULYSSES ST NE
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55434-3767
Practice Address - Country:US
Practice Address - Phone:763-754-7300
Practice Address - Fax:763-754-2561
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GREAT LAKES MANAGEMENT COMPANY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-04-28
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN375259251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health