Provider Demographics
NPI:1598710337
Name:REACHING OUT HOME HEALTH CARE INC.
Entity Type:Organization
Organization Name:REACHING OUT HOME HEALTH CARE INC.
Other - Org Name:CLASS 'A' HOME HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:MCDANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-327-8294
Mailing Address - Street 1:1415 E US HIGHWAY 169
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55744-3238
Mailing Address - Country:US
Mailing Address - Phone:218-327-8294
Mailing Address - Fax:218-327-1422
Practice Address - Street 1:1415 E US HIGHWAY 169
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55744-3238
Practice Address - Country:US
Practice Address - Phone:218-327-8294
Practice Address - Fax:218-327-1422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN337940251E00000X
MN335606251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN331846OtherCLASS A HOME HEALTH CARE
MN243447400Medicaid
MN786663000Medicaid
MN337940OtherCLASS F HOME CARE PROVIDE
MN331976OtherHOUSING WITH SERVICES
MN856476100OtherDHS PCA PROVIDER