Provider Demographics
NPI:1700685211
Name:GENTLE TOUCH HEALTH INITIATIVES, LLC
Entity type:Organization
Organization Name:GENTLE TOUCH HEALTH INITIATIVES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF ASSISTED LIVING OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:ANGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BANTLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-202-5037
Mailing Address - Street 1:12755 HIGHWAY 55 STE J-125
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55441-3837
Mailing Address - Country:US
Mailing Address - Phone:632-025-0377
Mailing Address - Fax:
Practice Address - Street 1:201 1ST ST NE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:MN
Practice Address - Zip Code:55313-1550
Practice Address - Country:US
Practice Address - Phone:763-682-5489
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility