Healthcare Provider Details

I. General information

NPI: 1437324324
Provider Name (Legal Business Name): REPLACEMENT RESERVES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2008
Last Update Date: 07/22/2021
Certification Date: 07/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1007 E 14TH ST
MINNEAPOLIS MN
55404-1314
US

IV. Provider business mailing address

1007 E 14TH ST
MINNEAPOLIS MN
55404-1314
US

V. Phone/Fax

Practice location:
  • Phone: 612-238-5201
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number339763
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: SEELOCHANI STADTHERR
Title or Position: DIRECTOR OF REIMBURSEMENT
Credential:
Phone: 952-855-5041