1598710337 NPI number — REACHING OUT HOME HEALTH CARE INC.

Table of content: (NPI 1598710337)

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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