Provider Demographics
NPI:1891321485
Name:RELIACARE HOME HEALTH INC
Entity Type:Organization
Organization Name:RELIACARE HOME HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:YOUMANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-366-1381
Mailing Address - Street 1:883 SAINT ANTHONY AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-4736
Mailing Address - Country:US
Mailing Address - Phone:612-366-1381
Mailing Address - Fax:651-298-0972
Practice Address - Street 1:883 SAINT ANTHONY AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-4736
Practice Address - Country:US
Practice Address - Phone:612-366-1381
Practice Address - Fax:651-298-0972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-16
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
A008683000OtherDEPARTMENT OF HUMAN SERVICES