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General NPI Number Information
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NPI Number | 1992811434
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Entity Type | Organization
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Legal Business Name | MINNEWASKA HOME CARE INC
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 10/05/2015
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Provider Practice Location Address
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Address Line | 605 MAIN STREET
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City | STARBUCK
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State | MN
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Zip | 56381-0040
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Country | US
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Telephone | 320-239-7259
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Fax | 320-239-7263
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Provider Business Mailing Address
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Address Line | PO BOX 40 605 MAIN STREET
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City | STARBUCK
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State | MN
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Zip | 56381-0040
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Country | US
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Telephone | 320-239-7259
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Fax | 320-239-7263
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. CHRISTOPHER ROBIN KNOLL
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Credential |
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Telephone | 320-239-7104
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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 | MN03853
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License Number State | MN
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