Organization
REGENCY HOME HEALTH CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEAN ANN JOHNSON (ADMINISTRATOR)
(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
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
706167600
—
MN
01
—
F146049683111
DRIVERS LICENSE
—
Enumeration date
11/12/2015
Last updated
03/25/2020
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