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General NPI Number Information
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NPI Number | 1306142344
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Entity Type | Organization
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Legal Business Name | AT HOME HEALTH CARE INC.
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Dates
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Enumeration Date | 02/09/2011
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Last Update Date | 02/09/2011
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Provider Practice Location Address
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Address Line | 1601 128TH LANE NW
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City | COON RAPIDS
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State | MN
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Zip | 55448
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Country | US
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Telephone | 763-381-4448
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Fax |
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Provider Business Mailing Address
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Address Line | 1601 128TH LANE NW
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City | COON RAPIDS
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State | MN
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Zip | 55448
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Country | US
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Telephone | 763-381-4448
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JESSICA EASTER
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Credential |
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Telephone | 763-381-4448
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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 | 350692
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License Number State | MN
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