Healthcare Provider Details

I. General information

NPI: 1093225930
Provider Name (Legal Business Name): THE ANCHOR HEALTH AND SUPPOET SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2017
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1521 93RD LN NE STE 100
BLAINE MN
55449-4432
US

IV. Provider business mailing address

1521 93RD LN NE STE 100
BLAINE MN
55449-4432
US

V. Phone/Fax

Practice location:
  • Phone: 612-964-8772
  • Fax: 612-587-1264
Mailing address:
  • Phone: 612-964-8772
  • Fax: 612-587-1264

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251T00000X
TaxonomyPACE Provider Organization
License Number1083352-1-HCBS
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number1083352-1-HCBS
License Number StateMN
# 3
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: SARAH WADEHYENE APPLETON
Title or Position: OWNER/REGISTERED AGENT
Credential: 245D HCBS
Phone: 612-964-8772