Provider Demographics
NPI:1497065460
Name:ABLE PALMS HOME HEALTH OF MINNEAPOLIS, LLC
Entity Type:Organization
Organization Name:ABLE PALMS HOME HEALTH OF MINNEAPOLIS, LLC
Other - Org Name:ABLE CARE CONNECT HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:WEICHERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-361-8000
Mailing Address - Street 1:1107 HAZELTINE BOULEVARD
Mailing Address - Street 2:STE 526
Mailing Address - City:CHASKA
Mailing Address - State:MN
Mailing Address - Zip Code:55318-1065
Mailing Address - Country:US
Mailing Address - Phone:952-361-8918
Mailing Address - Fax:952-361-8060
Practice Address - Street 1:3701 CHANDLER DR NE APT 526
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55421-4443
Practice Address - Country:US
Practice Address - Phone:612-209-0425
Practice Address - Fax:651-202-4422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-08
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN248123Medicare Oscar/Certification