Provider Demographics
NPI:1396213948
Name:CHEPSTON HOME HEALTHCARE LLC
Entity Type:Organization
Organization Name:CHEPSTON HOME HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WASHINGTON
Authorized Official - Middle Name:S
Authorized Official - Last Name:TOE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-644-7047
Mailing Address - Street 1:8201 SIERRA PKWY
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55444-1569
Mailing Address - Country:US
Mailing Address - Phone:612-644-7047
Mailing Address - Fax:
Practice Address - Street 1:8201 SIERRA PKWY
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55444-1569
Practice Address - Country:US
Practice Address - Phone:612-644-7047
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-12
Last Update Date:2018-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherHOME HEALTH CARE