Organization
REGENCY HOME HEALTHCARE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JEAN ANN JOHNSON RN/RRT (ADMINISTRATOR/OWNER)
(651) 488-4655
Entity
Organization
Contact information
Practice address
10467 93RD AVE N, MAPLE GROVE, MN 55369-4112
(651) 488-4655
(651) 488-4656
Mailing address
10467 93RD AVE N, MAPLE GROVE, MN 55369-4112
(651) 488-4655
(651) 488-4656
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
329047
MN
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
164395
UCARE MINNESOTA
MN
01
—
3R83RE
BCBS
MN
01
—
59-00256
MEDICA
MN
05
—
706167600
—
MN
01
—
96068
HEALTH PARTNERS
MN
Enumeration date
06/07/2006
Last updated
05/05/2020
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