1225659428 NPI number — CAREPOINT HOME HEALTH LLC

Table of content: (NPI 1225659428)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225659428 NPI number — CAREPOINT HOME HEALTH LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CAREPOINT HOME HEALTH LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225659428
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/25/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8170 OLD CARRIAGE CT STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SHAKOPEE
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55379-3169
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
651-998-2400
Provider Business Mailing Address Fax Number:
866-359-1633

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14560 WILDS PKWY NW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PRIOR LAKE
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55372-3219
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
651-998-2400
Provider Business Practice Location Address Fax Number:
866-359-1633
Provider Enumeration Date:
04/29/2020

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
DIXON
Authorized Official First Name:
VERLENE
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF OPERATIONS
Authorized Official Telephone Number:
651-998-2400

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: A443477000 . This is a "MINNESOTA DEPARTMENT OF HUMAN SERVICES" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: A815137000 . This is a "MINNESOTA DEPARTMENT OF HUMAN SERVICES" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".