=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669003885
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MAHADD HEALTH SOLUTIONS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/27/2020
-----------------------------------------------------
Last Update Date | 08/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1895 COUNTY ROAD E E STE 210
-----------------------------------------------------
City | WHITE BEAR LAKE
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55110-4690
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 651-797-4745
-----------------------------------------------------
Fax | 651-348-8716
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1895 COUNTY ROAD E E STE 210
-----------------------------------------------------
City | WHITE BEAR LAKE
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55110-4690
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 612-913-8414
-----------------------------------------------------
Fax | 651-348-8716
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VP OPERATIONS
-----------------------------------------------------
Name | PAULETTE DUNCAN
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 763-439-9963
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------