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NPI Code Detail

MEDICARE: MINNESOTA IN HOME HEALTH CARE LLC

MEDICARE: MINNESOTA IN HOME HEALTH CARE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251J00000XNursing Care AgencyR197194-7MN

General Provider Information

NPI Number : 1508160235
Entity Type Code : Organization
Provider Name (Legal Business Name) : MINNESOTA IN HOME HEALTH CARE LLC
Provider Business Mailing Address
First Line : 2239 LAKEAIRES BLVD
Second Line :
City : WHITE BEAR LAKE
State : MN
Zip : 55110-4329
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2239 LAKEAIRES BLVD
Second Line :
City : WHITE BEAR LAKE
State : MN
Zip : 55110-4329
Country : US
Telephone Number : 651-231-9536
Fax Number :
Authorized Official
Title or Position : BUSINESS MANAGER
Name : MR. JAMES B REESE
Credential :
Telephone Number : 651-231-9536
Provider Enumeration Date : 01/10/2011
Last Update Date : 01/10/2011

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Directions to “MINNESOTA IN HOME HEALTH CARE LLC ” Practice Location

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