Healthcare Provider Details

I. General information

NPI: 1033740717
Provider Name (Legal Business Name): B HOMECARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2020
Last Update Date: 01/30/2020
Certification Date: 01/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

626 MAIN ST N
CAMBRIDGE MN
55008-1271
US

IV. Provider business mailing address

626 MAIN ST N
CAMBRIDGE MN
55008-1271
US

V. Phone/Fax

Practice location:
  • Phone: 763-689-8984
  • Fax: 763-689-1170
Mailing address:
  • Phone: 763-689-8984
  • Fax: 763-689-1170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code385HR2065X
TaxonomyChild Physical Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: BRANDY ANN HERBST
Title or Position: PRESIDENT/ OWNER
Credential:
Phone: 763-401-9466