Provider Demographics
NPI:1184371650
Name:HOME DOCTOR FOR YOU MINNESOTA, INC
Entity type:Organization
Organization Name:HOME DOCTOR FOR YOU MINNESOTA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-334-7777
Mailing Address - Street 1:PO BOX 1710
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46082-1710
Mailing Address - Country:US
Mailing Address - Phone:866-334-7777
Mailing Address - Fax:866-878-0094
Practice Address - Street 1:10550 WAYZATA BLVD STE 1
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-1523
Practice Address - Country:US
Practice Address - Phone:763-545-3131
Practice Address - Fax:866-878-0094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-04
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care