Organization Active NPI

Forest Lake Home Care Inc

  • Home Health Agency
  • Forest Lake, MN
National Provider Identifier
1710238654
Registry record updated Jun 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
FOREST LAKE HOME CARE INC
Practice address
631 Lake St S
Forest Lake, MN 55025-2631
Phone
(651) 272-5195
Fax
(651) 395-2934
NPI assigned
Oct 1, 2012
Last updated
Jun 26, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2014

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

Authorized official

Name
Paul Kreger
Title
Owner
Phone
(651) 272-5195

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

631 Lake St S
Forest Lake, MN 55025-2631

Mailing address

631 Lake St S
Forest Lake, MN 55025-2631
Phone (651) 272-5195

National Provider Directory

National Provider Directory

Locations

631 Lake St S
Forest Lake, MN 55025
Phone (651) 272-5195

NPI Registry JSON

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

{
    "created_epoch": "1349049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403740800000",
    "number": "1710238654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 LAKE ST S",
            "city": "FOREST LAKE",
            "state": "MN",
            "postal_code": "550252631",
            "telephone_number": "651-272-5195",
            "fax_number": "651-395-2934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 LAKE ST S",
            "city": "FOREST LAKE",
            "state": "MN",
            "postal_code": "550252631",
            "telephone_number": "651-272-5195",
            "fax_number": "651-395-2934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOREST LAKE HOME CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-01",
        "last_updated": "2014-06-26",
        "status": "A",
        "authorized_official_last_name": "KREGER",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-272-5195"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Lake, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2014; 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.