| Regency Home Health Care | |
|
10467 93rd Ave N Maple Grove MN 55369-4112 | |
| (651) 488-4655 | |
| (651) 488-4656 |
| Full Name | Regency Home Health Care |
|---|---|
| Speciality | Home Health |
| Location | 10467 93rd Ave N, Maple Grove, Minnesota |
| Authorized Official Name and Position | Jean Ann Johnson (ADMINISTRATOR) |
| Authorized Official Contact | 6514884655 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Regency Home Health Care 10467 93rd Ave N Maple Grove MN 55369-4112 Ph: (651) 488-4655 | Regency Home Health Care 10467 93rd Ave N Maple Grove MN 55369-4112 Ph: (651) 488-4655 |
| NPI Number | 1669845707 |
|---|---|
| Provider Enumeration Date | 11/12/2015 |
| Last Update Date | 03/25/2020 |
| Certification Date | 03/25/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669845707 | NPI | - | NPPES |
| F146049683111 | Other | DRIVERS LICENSE | |
| 706167600 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 251E00000X | Home Health | (* (Not Available)) | Primary |
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