Healthcare Provider Details

I. General information

NPI: 1538341649
Provider Name (Legal Business Name): REM SOUTHWEST SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2007
Last Update Date: 03/05/2023
Certification Date: 03/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 SAINT OLAF AVE N
CANBY MN
56220-1372
US

IV. Provider business mailing address

6600 FRANCE AVE S
EDINA MN
55435-1805
US

V. Phone/Fax

Practice location:
  • Phone: 507-223-5633
  • Fax: 507-223-5659
Mailing address:
  • Phone: 952-922-6776
  • Fax: 952-922-6885

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: BRETT IAN COHEN
Title or Position: COO
Credential:
Phone: 800-388-5150