Provider Demographics
NPI:1295380020
Name:UP NORTH HHC SERVICE CORPORATION
Entity Type:Organization
Organization Name:UP NORTH HHC SERVICE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN, OWNER, MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LEIGHA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HUFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN,BSN,PHN
Authorized Official - Phone:763-807-9924
Mailing Address - Street 1:17443 COUNTY ROAD 561
Mailing Address - Street 2:
Mailing Address - City:PENGILLY
Mailing Address - State:MN
Mailing Address - Zip Code:55775-2051
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17443 COUNTY ROAD 561
Practice Address - Street 2:
Practice Address - City:PENGILLY
Practice Address - State:MN
Practice Address - Zip Code:55775-2051
Practice Address - Country:US
Practice Address - Phone:763-807-9924
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-08
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health