Provider Demographics
NPI:1477612802
Name:WILD FLOWER HEALTH CARE SERVICES, INC.
Entity Type:Organization
Organization Name:WILD FLOWER HEALTH CARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAVAGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-551-4786
Mailing Address - Street 1:6000 BASS LAKE RD
Mailing Address - Street 2:SUITE # 208
Mailing Address - City:CRYSTAL
Mailing Address - State:MN
Mailing Address - Zip Code:55429-2700
Mailing Address - Country:US
Mailing Address - Phone:763-551-4786
Mailing Address - Fax:763-537-6817
Practice Address - Street 1:5200 ANNAPOLIS LN N
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55446-3550
Practice Address - Country:US
Practice Address - Phone:763-227-3527
Practice Address - Fax:763-537-6817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN332696251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health