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General NPI Number Information
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NPI Number | 1750712345
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Entity Type | Organization
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Legal Business Name | RJ'S HOME HEALTH CARE, LLC
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Dates
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Enumeration Date | 12/06/2013
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Last Update Date | 12/06/2013
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Provider Practice Location Address
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Address Line | 5875 TEAKWOOD LN N UNIT B
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City | PLYMOUTH
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State | MN
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Zip | 55442-1487
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Country | US
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Telephone | 731-442-9862
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Fax |
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Provider Business Mailing Address
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Address Line | 5875 TEAKWOOD LN N UNIT B
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City | PLYMOUTH
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State | MN
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Zip | 55442-1487
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Country | US
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Telephone | 731-442-9862
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RONNIE LORENZO GLYNN JR.
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Credential |
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Telephone | 731-442-9862
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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