NPI 1114666559

Organization Active NPI Home Health Agency · Champlin, MN

NPI 1114666559 · NPPES record last updated Jun 2, 2022

Key facts

NPI
1114666559
Entity type
Organization (NPI type 2)
Primary specialty
Home Health Agency 251E00000X
Practice address
10907 Xylon LN N
Champlin, MN 55316-3712
Phone
(763) 250-3079
NPI assigned
Jun 2, 2022
Organization subpart
No

Authorized official

Name
Nehemiah Otto Garley
Title
Director
Phone
(763) 250-3079

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Yes

Addresses

Primary practice location

10907 Xylon LN N
Champlin, MN 55316-3712

Mailing address

10907 Xylon LN N
Champlin, MN 55316-3712
Phone (763) 250-3079

Other identifiers

IdentifierTypeStateIssuer
01291977OtherMNPCA
01291977MedicaidMN

Other names

  • The Garson Group Doing business as

Other providers in Champlin, MN

All providers in Champlin, MN · Home Health Agency in Minnesota

Sources for this page

Verify at the official NPI Registry.