Provider Demographics
NPI:1396969085
Name:EXCEPTIONAL HOME HEALTH LLC
Entity type:Organization
Organization Name:EXCEPTIONAL HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:SELENE
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-521-1854
Mailing Address - Street 1:3107 PENN AVE N
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55411-1123
Mailing Address - Country:US
Mailing Address - Phone:612-521-1854
Mailing Address - Fax:612-521-1926
Practice Address - Street 1:3107 PENN AVE N
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55411-1123
Practice Address - Country:US
Practice Address - Phone:612-521-1854
Practice Address - Fax:612-521-1926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health