Provider Demographics
NPI:1053659516
Name:MINNESOTA HOME HEALTH CARE ONE, INC
Entity Type:Organization
Organization Name:MINNESOTA HOME HEALTH CARE ONE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:BANKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-705-8833
Mailing Address - Street 1:829 7TH ST E
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55106-4515
Mailing Address - Country:US
Mailing Address - Phone:651-705-8833
Mailing Address - Fax:651-705-8834
Practice Address - Street 1:829 7TH ST E
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55106-4515
Practice Address - Country:US
Practice Address - Phone:651-705-8833
Practice Address - Fax:651-705-8834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-17
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health