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Active NPI 1114666559 Organization (Entity Type 2)

Unknown

Home Health • Champlin, MN

About Unknown NPI 1114666559 Summary

Unknown is a verified healthcare organization specializing in Home Health operating in Champlin, MN. Located at 10907 XYLON LN N, this facility provides patient care and medical services under National Provider Identifier (NPI) 1114666559.

Administrative operations and authorized compliance are overseen by Nehemiah Garley (Director).

Facility Location & Contact Primary Location

Facility Address

10907 Xylon Ln N

Champlin, MN 553163712

Telephone 7632503079

Authorized Official Information

Authorized Contact Name

Nehemiah Garley

Title / Role

Director

Official Telephone

7632503079

Facility Classifications & Specialties

Home Health Primary Taxonomy

NUCC Taxonomy Code: 251E00000X

A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.

Facility & Registry History Timeline

Chronological log of verified NPI organization updates, branch relocations, and registry updates

5 Historical Events
NPI Profile Active June 02, 2022

NPI status registered as active in NPPES database

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Updated Practice Location June 02, 2022

Registered at 10907 XYLON LN N, CHAMPLIN, MN 553163712 (Tel: 7632503079)

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Updated Business Mailing Address June 02, 2022

Registered at 10907 XYLON LN N, CHAMPLIN, MN 553163712 (Tel: 7632503079)

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Medical Taxonomy / Specialty Registered (Primary Specialty) June 02, 2022

Home Health

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Initial NPI Registration & Enumeration June 02, 2022

First registered as active Healthcare Organization in NPPES Database.

Patient & Community Reviews

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NPI Organization Metadata

NPI Number: 1114666559
Entity Type:
Organization Organization (Hospital, Clinic, Group Practice) (Type 2 NPI)
Enumeration Date: June 02, 2022
Last Update: June 02, 2022

Mailing Address

10907 Xylon Ln N

Champlin, MN 553163712

Phone: 7632503079

Public Domain Record This organization profile is sourced from public domain datasets published by CMS and NPPES under FOIA.
⚠️ Medical Disclaimer

Facility details are provided for public information only. In case of a medical emergency, call 911 immediately.