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General NPI Number Information
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NPI Number | 1013351261
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Entity Type | Organization
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Legal Business Name | MINNESOTA HOME HEALTH CARE ONE
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Dates
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Enumeration Date | 04/18/2013
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Last Update Date | 04/18/2013
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Provider Practice Location Address
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Address Line | 829 7TH ST E
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City | SAINT PAUL
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State | MN
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Zip | 55106-4515
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Country | US
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Telephone | 651-705-8833
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Fax | 651-705-8834
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Provider Business Mailing Address
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Address Line | 829 7TH ST E
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City | SAINT PAUL
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State | MN
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Zip | 55106-4515
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Country | US
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Telephone | 651-705-8833
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Fax | 651-705-8834
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Authorized Official
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Title or Position | OWNER
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Name | EUGENE HENRY BANKS
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Credential |
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Telephone | 651-705-8833
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 361486
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License Number State | MN
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