Provider Demographics
NPI:1124718614
Name:STUCK HOLDINGS, INC.
Entity type:Organization
Organization Name:STUCK HOLDINGS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FRANCHISE OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:STUCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-544-5988
Mailing Address - Street 1:3115 GOLF TER
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56301-9637
Mailing Address - Country:US
Mailing Address - Phone:612-850-9727
Mailing Address - Fax:
Practice Address - Street 1:9684 63RD AVE N
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-6200
Practice Address - Country:US
Practice Address - Phone:763-544-5988
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-09
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care