Provider Demographics
NPI:1417256645
Name:ALL GOOD HOME CARE INC.
Entity Type:Organization
Organization Name:ALL GOOD HOME CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:TOD
Authorized Official - Last Name:ALLGOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-393-2406
Mailing Address - Street 1:9250 LAKEWOOD SHORE RD NW
Mailing Address - Street 2:
Mailing Address - City:RICE
Mailing Address - State:MN
Mailing Address - Zip Code:56367-7605
Mailing Address - Country:US
Mailing Address - Phone:320-393-2406
Mailing Address - Fax:320-393-2455
Practice Address - Street 1:9250 LAKEWOOD SHORE RD NW
Practice Address - Street 2:
Practice Address - City:RICE
Practice Address - State:MN
Practice Address - Zip Code:56367-7605
Practice Address - Country:US
Practice Address - Phone:320-393-2406
Practice Address - Fax:320-393-2455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-28
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN348282251J00000X
253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNA148105000Medicaid