PROVISIONAL HOME HEALTH LLC
NPI 1659659811
Home Health in Rockford, MN

Active since July 21, 2011
4110 MAPLE HURST DR S, ROCKFORD, MN 55373(763) 575-7281 Get Directions Write a Review

NPPES record last updated: July 21, 2011. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Provisional Home Health Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROVISIONAL HOME HEALTH LLC (NPI 1659659811) is a healthcare organization registered as a home health in Rockford, Minnesota and active in the NPI registry since July 2011. The organization lists Kristine Ann Carr, Director Of Nursing, as its authorized official.

NPPES Registry Identity

NPI1659659811
Entity TypeOrganization
Primary Taxonomy251E00000X
Legal Business NamePROVISIONAL HOME HEALTH LLC
Location Address4110 MAPLE HURST DR SRockford, MN 55373-4565
Mailing Address4110 Maple Hurst Dr SRockford, MN 55373-4565 · (763) 575-7281
Organization SubpartNo
Authorized OfficialKristine Ann CarrDirector Of Nursing · (763) 575-7281
Enumeration DateJuly 21, 2011
NPI 1659659811 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyHome HealthAgencies
Taxonomy Code251E00000X
License Licensed in MN · 353499
Definition

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.

4110 MAPLE HURST DR S, Rockford, MN 55373

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Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1659659811, enumerated as an "organization" on July 21, 2011.

The provider is located at 4110 MAPLE HURST DR S ROCKFORD, MN 55373 and the phone number is (763) 575-7281.

Home Health with taxonomy code 251E00000X.