Provider Demographics
NPI:1417197724
Name:AUDRIE HOME HEALTH CARE LLC.
Entity Type:Organization
Organization Name:AUDRIE HOME HEALTH CARE LLC.
Other - Org Name:AUDRIE HOME HEALTH CARE LLC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:PIERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-560-9212
Mailing Address - Street 1:7040 LAKELAND AVE N
Mailing Address - Street 2:STE. 205
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55428-5600
Mailing Address - Country:US
Mailing Address - Phone:763-560-9212
Mailing Address - Fax:763-560-9636
Practice Address - Street 1:7040 LAKELAND AVE N
Practice Address - Street 2:STE. 205
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55428-5600
Practice Address - Country:US
Practice Address - Phone:763-560-9212
Practice Address - Fax:763-560-9636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-26
Last Update Date:2011-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health