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General NPI Number Information
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NPI Number | 1083438923
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Entity Type | Organization
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Legal Business Name | BLAINE HEALTH SERVICES LLC
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Dates
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Enumeration Date | 11/07/2024
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 13250 NASSAU CT NE
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City | BLAINE
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State | MN
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Zip | 55449-4989
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Country | US
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Telephone | 763-318-5008
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Fax |
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Provider Business Mailing Address
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Address Line | 13250 NASSAU CT NE
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City | BLAINE
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State | MN
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Zip | 55449-4989
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Country | US
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Telephone | 763-318-5008
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | VALENTINE B OBWOGI
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Credential |
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Telephone | 763-318-5008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 315D00000X
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Taxonomy Name | Inpatient Hospice
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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