Diversey Home Care, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

360193 Issued in MN

Legal business name

DIVERSEY HOME CARE, LLC

Practice address

6631 Urbandale LN N
Maple Grove, MN 55311-1374

Phone

(952) 388-7368

NPI assigned

Dec 4, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Winonna Palo, RN

Title

Care Manager/Owner

Phone

(952) 388-7368

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1354579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354579200000",
    "number": "1124363056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6631 URBANDALE LN N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553111374",
            "telephone_number": "952-388-7368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6631 URBANDALE LN N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553111374",
            "telephone_number": "952-388-7368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSEY HOME CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-04",
        "last_updated": "2012-12-04",
        "status": "A",
        "authorized_official_last_name": "PALO",
        "authorized_official_first_name": "WINONNA",
        "authorized_official_title_or_position": "CARE MANAGER/OWNER",
        "authorized_official_telephone_number": "952-388-7368",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MN",
            "license": "360193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Maple Grove, MN
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• Home Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2012; 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.