Healthcare Provider Details

I. General information

NPI: 1639839327
Provider Name (Legal Business Name): REBOUND HOME HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2021
Last Update Date: 02/22/2022
Certification Date: 02/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9839 HAMLET LN S
COTTAGE GROVE MN
55016-3898
US

IV. Provider business mailing address

9839 HAMLET LN S
COTTAGE GROVE MN
55016-3898
US

V. Phone/Fax

Practice location:
  • Phone: 651-354-9893
  • Fax:
Mailing address:
  • Phone: 651-354-9893
  • Fax:

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 Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: JAMES K KAIGE
Title or Position: MANAGER
Credential:
Phone: 651-354-9893