Healthcare Provider Details

I. General information

NPI: 1801295399
Provider Name (Legal Business Name): HHC SERVICES MN, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2014
Last Update Date: 01/09/2024
Certification Date: 01/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3227 OAK RIDGE LOOP E
WEST FARGO ND
58078-8482
US

IV. Provider business mailing address

4302 13TH AVE S SUITE 4-375
FARGO ND
58103-3395
US

V. Phone/Fax

Practice location:
  • Phone: 701-850-2000
  • Fax:
Mailing address:
  • Phone: 701-850-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberAPPLIED FOR
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number1464610
License Number StateND
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number1464610
License Number StateND
# 5
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number1464610
License Number StateND
# 6
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number1464610
License Number StateND

VIII. Authorized Official

Name: MR. JOSHUA L GILLELAND
Title or Position: EXECUTIVE DIRECTOR
Credential: CSA, CBIS
Phone: 701-850-2000