NPI 1689797102 · live from the CMS NPI Registry
Acute Home Health Care Of Mn
Custodial Care Facility, Adult Care Home in Eden Prairie, MN. National Provider Identifier 1689797102, active.
NPI record
| NPI | 1689797102 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Custodial Care Facility, Adult Care Home 311ZA0620X |
| Practice location | 6385 Old Shady Oak Rd Ste 250, Eden Prairie, MN 55344 |
| Practice phone | 952-361-0080 |
| Mailing address | 6385 Old Shady Oak Rd, Ste 250, Eden Prairie, MN 55344 |
| Enumerated | April 9, 2007 |
| Last updated | November 11, 2018 |
| Authorized official | Kimloan Sloss, Director Of Nursing |
| Other names | Tranquil Living |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Home Health | 251E00000X | — |
| Custodial Care Facility, Adult Care Home | 311ZA0620X | 1039690-2-AFC (MN) |
| Custodial Care Facility, Adult Care Home | 311ZA0620X | 34050 (MN) |
| Custodial Care Facility, Adult Care Home primary | 311ZA0620X | 1039688-2-AFC (MN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.