Provider Demographics
NPI:1770718926
Name:RANGE DEVELOPMENT COMPANY
Entity type:Organization
Organization Name:RANGE DEVELOPMENT COMPANY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:P
Authorized Official - Last Name:SCHROETTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-263-4157
Mailing Address - Street 1:2229 3RD AVE E
Mailing Address - Street 2:P.O. BOX 786
Mailing Address - City:HIBBING
Mailing Address - State:MN
Mailing Address - Zip Code:55746-1911
Mailing Address - Country:US
Mailing Address - Phone:218-263-4157
Mailing Address - Fax:218-263-8534
Practice Address - Street 1:2229 3RD AVE E
Practice Address - Street 2:
Practice Address - City:HIBBING
Practice Address - State:MN
Practice Address - Zip Code:55746-1911
Practice Address - Country:US
Practice Address - Phone:218-263-4157
Practice Address - Fax:218-263-8534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-18
Last Update Date:2009-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN340137310400000X
MN34092310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility