Provider Demographics
NPI:1750712345
Name:RJ'S HOME HEALTH CARE, LLC
Entity type:Organization
Organization Name:RJ'S HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RONNIE
Authorized Official - Middle Name:LORENZO
Authorized Official - Last Name:GLYNN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:731-442-9862
Mailing Address - Street 1:5875 TEAKWOOD LN N
Mailing Address - Street 2:UNIT B
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55442-1487
Mailing Address - Country:US
Mailing Address - Phone:731-442-9862
Mailing Address - Fax:
Practice Address - Street 1:5875 TEAKWOOD LN N
Practice Address - Street 2:UNIT B
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55442-1487
Practice Address - Country:US
Practice Address - Phone:731-442-9862
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-06
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility