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General NPI Number Information
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NPI Number | 1750803367
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Entity Type | Organization
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Legal Business Name | HARVEST MANAGEMENT GROUP LLC
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Dates
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Enumeration Date | 07/14/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 11670 FOUNTAINS DR STE 200
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City | MAPLE GROVE
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State | MN
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Zip | 55369-7195
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Country | US
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Telephone | 763-777-4332
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Fax | 763-309-9561
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Provider Business Mailing Address
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Address Line | 11670 FOUNTAINS DR STE 200
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City | MAPLE GROVE
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State | MN
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Zip | 55369-7195
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Country | US
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Telephone | 763-777-4332
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Fax | 763-309-9561
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | LAUREN MCAFEE
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Credential |
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Telephone | 763-777-4232
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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 | 381835
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License Number State | MN
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