Provider Demographics
NPI:1275535569
Name:VOLUNTEERS OF AMERICA HOME HEALTH SERVICES OF SOUTHEASTERN MINNESOTA
Entity Type:Organization
Organization Name:VOLUNTEERS OF AMERICA HOME HEALTH SERVICES OF SOUTHEASTERN MINNESOTA
Other - Org Name:STANLEY JONES & ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:GAVIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-983-4249
Mailing Address - Street 1:1800 HIGH POINTE LN NW STE 250
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-3007
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1800 HIGH POINTE LN NW STE 250
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-3007
Practice Address - Country:US
Practice Address - Phone:507-322-5740
Practice Address - Fax:507-322-5716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-01
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN383366251E00000X
261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN383366Medicaid
FM28524OtherHEALTH PARTNERS HOME HEAL
MN212055101Medicaid
MN246548Medicare Oscar/Certification
MN8345STOtherBCBS HOME HEALTH
MN6G075STOtherBCBS SPEECH
MN247180Medicare ID - Type UnspecifiedHOME HEALTH
MN212055100Medicaid
MN6G078STOtherBCBS OT
MN59385OtherHEALTH PARTNERS REHAB
MN172385OtherU-CARE
MN80545OtherMMSI