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General NPI Number Information
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NPI Number | 1821267758
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Entity Type | Organization
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Legal Business Name | IN HOME PERSONAL CARE HOME HEALTH INC
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Dates
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Enumeration Date | 02/25/2008
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Last Update Date | 02/25/2008
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Provider Practice Location Address
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Address Line | 8441 WAYZATA BLVD SUITE 130
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City | GOLDEN VALLEY
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State | MN
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Zip | 55426-1344
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Country | US
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Telephone | 763-546-1000
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Fax | 763-546-1018
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Provider Business Mailing Address
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Address Line | 8441 WAYZATA BLVD SUITE 130
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City | GOLDEN VALLEY
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State | MN
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Zip | 55426-1344
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Country | US
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Telephone | 763-546-1000
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Fax | 763-546-1018
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Authorized Official
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Title or Position | FOUNDER
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Name | KEVIN L SULLIVAN
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Credential |
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Telephone | 763-546-1000
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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 | 335349
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License Number State | MN
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