Provider Demographics
NPI:1245410299
Name:ACCESS PSYCHIATRIC HOME HEALTH
Entity Type:Organization
Organization Name:ACCESS PSYCHIATRIC HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DARLENE
Authorized Official - Middle Name:SYLVIA
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:RN ,MPH
Authorized Official - Phone:218-259-3239
Mailing Address - Street 1:1506 SW 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55744-4113
Mailing Address - Country:US
Mailing Address - Phone:218-259-1133
Mailing Address - Fax:
Practice Address - Street 1:1506 SW 3RD AVE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55744-4113
Practice Address - Country:US
Practice Address - Phone:218-259-1133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-07
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health