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Organization

WILDROSE HOME HEALTH SERVICES, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PAUL HAGEN (CEO)
(507) 625-8938
Entity
Organization

Contact information

Practice address
1021 N RIVERFRONT DR, MANKATO, MN 56001-3341
(507) 625-8938
(507) 625-9038
Mailing address
18396 568TH AVE, MANKATO, MN 56001-6649
(507) 625-8938
(507) 625-9038

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
NA
MN
253Z00000X
In Home Supportive Care Agency

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003610200
MN
Enumeration date
08/27/2007
Last updated
10/08/2010
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