Healthcare Provider Details

I. General information

NPI: 1689797102
Provider Name (Legal Business Name): ACUTE HOME HEALTH CARE OF MN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 11/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6385 OLD SHADY OAK RD STE 250
EDEN PRAIRIE MN
55344-7705
US

IV. Provider business mailing address

6385 OLD SHADY OAK RD STE 250
EDEN PRAIRIE MN
55344-3299
US

V. Phone/Fax

Practice location:
  • Phone: 952-361-0080
  • Fax:
Mailing address:
  • Phone: 952-361-0080
  • Fax: 952-448-1996

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number1039690-2-AFC
License Number StateMN
# 3
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number34050
License Number StateMN
# 4
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number1039688-2-AFC
License Number StateMN

VIII. Authorized Official

Name: MS. KIMLOAN SLOSS
Title or Position: DIRECTOR OF NURSING
Credential: RN, PHN
Phone: 952-361-0080