Provider Demographics
NPI:1942976899
Name:MINNESOTA HOME HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:MINNESOTA HOME HEALTH SERVICES LLC
Other - Org Name:MINNESOTA HOME HEALTH SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/ OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BECKY
Authorized Official - Middle Name:L
Authorized Official - Last Name:GARIVAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-410-3785
Mailing Address - Street 1:6 MICHAEL LN
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:MN
Mailing Address - Zip Code:55033-3937
Mailing Address - Country:US
Mailing Address - Phone:651-410-3785
Mailing Address - Fax:612-884-9053
Practice Address - Street 1:6472 UPPER 54TH ST N
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55128-1110
Practice Address - Country:US
Practice Address - Phone:612-512-3581
Practice Address - Fax:651-340-8072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-20
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care