1598710337 NPI number — REACHING OUT HOME HEALTH CARE INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598710337 NPI number — REACHING OUT HOME HEALTH CARE INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REACHING OUT HOME HEALTH CARE INC.
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:
6
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:
1598710337
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/25/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1415 E US HIGHWAY 169
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRAND RAPIDS
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55744-3238
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
218-327-8294
Provider Business Mailing Address Fax Number:
218-327-1422

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1415 E US HIGHWAY 169
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GRAND RAPIDS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55744-3238
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
218-327-8294
Provider Business Practice Location Address Fax Number:
218-327-1422
Provider Enumeration Date:
05/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MCDANIEL
Authorized Official First Name:
JOEL
Authorized Official Middle Name:
L
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
218-327-8294

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  337940 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: 335606 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 331846 . This is a "CLASS A HOME HEALTH CARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 243447400 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 786663000 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 337940 . This is a "CLASS F HOME CARE PROVIDE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 331976 . This is a "HOUSING WITH SERVICES" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 856476100 . This is a "DHS PCA PROVIDER" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




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