State Wide Home Health LLC

Primary specialty

Nursing Care AgencyTaxonomy code 251J00000X

Legal business name

STATE WIDE HOME HEALTH LLC

Practice address

8617 Edinbrook Xing
Suite 131
Brooklyn Park, MN 55443-4016

Phone

(763) 202-3923

Fax

(952) 217-4513

NPI assigned

Oct 22, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michael Wayne Foster

Title

Owner

Phone

(763) 202-3923

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1382400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382400000000",
    "number": "1053749440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8617 EDINBROOK XING",
            "address_2": "SUITE 131",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554434016",
            "telephone_number": "763-202-3923",
            "fax_number": "952-217-4513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8617 EDINBROOK XING",
            "address_2": "SUITE 131",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554434016",
            "telephone_number": "763-202-3923",
            "fax_number": "952-217-4513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE WIDE HOME HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-22",
        "last_updated": "2013-10-22",
        "status": "A",
        "authorized_official_last_name": "FOSTER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "763-202-3923"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nursing Care Agency in Brooklyn Park, MN
• Providers in Brooklyn Park, MN by specialty
• Nursing Care Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.