Healthcare Provider Details

I. General information

NPI: 1841944394
Provider Name (Legal Business Name): SHS-MN, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2022
Last Update Date: 05/13/2022
Certification Date: 05/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16430 45TH AVE N
PLYMOUTH MN
55446-2048
US

IV. Provider business mailing address

16430 45TH AVE N
PLYMOUTH MN
55446-2048
US

V. Phone/Fax

Practice location:
  • Phone: 763-694-0165
  • Fax:
Mailing address:
  • Phone: 763-694-0165
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY NERMYR
Title or Position: OWNER
Credential:
Phone: 763-694-0165