Provider Demographics
NPI:1841297140
Name:RECOVER HEALTH OF MINNESOTA, INC.
Entity type:Organization
Organization Name:RECOVER HEALTH OF MINNESOTA, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCKHALTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-464-8000
Mailing Address - Street 1:400 INTERSTATE NORTH PKWY SE STE 1600
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-5047
Mailing Address - Country:US
Mailing Address - Phone:470-464-8000
Mailing Address - Fax:
Practice Address - Street 1:60 10TH AVE S STE 60
Practice Address - Street 2:
Practice Address - City:WAITE PARK
Practice Address - State:MN
Practice Address - Zip Code:56387-1055
Practice Address - Country:US
Practice Address - Phone:320-774-0777
Practice Address - Fax:320-774-0779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-30
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1027525OtherPREFERRED ONE PROVIDER #
MN528816900Medicaid
MN59-00085OtherMEDICA PROVIDER NUMBER
MN7Z40REOtherBCBS MN PROVIDER #
MN02312OtherMN HEALTH FACILITY IDENTIFIER NUMBER
MN00007127502OtherPRIMEWEST PROVIDER NUMBER
MN111186OtherUCARE PROVIDER NUMBER
MN21613OtherHEALTHPARTNERS PROVIDER #
MN1027525OtherPREFERRED ONE PROVIDER #