Provider Demographics
NPI:1417283516
Name:HD CORP
Entity Type:Organization
Organization Name:HD CORP
Other - Org Name:ACCESSIBLE HOME HEALTH CARE OF WESTERN MINNEAPOLIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JON
Authorized Official - Middle Name:
Authorized Official - Last Name:DEWITTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-546-5488
Mailing Address - Street 1:13911 RIDGEDALE DR.
Mailing Address - Street 2:404C
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55305
Mailing Address - Country:US
Mailing Address - Phone:952-546-5488
Mailing Address - Fax:952-546-5496
Practice Address - Street 1:13911 RIDGEDALE DR
Practice Address - Street 2:404C
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-1771
Practice Address - Country:US
Practice Address - Phone:952-546-5488
Practice Address - Fax:952-546-5496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-23
Last Update Date:2009-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNHE01084-04251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health