Provider Demographics
NPI:1154870459
Name:HUMMING BIRD HOME CARE
Entity type:Organization
Organization Name:HUMMING BIRD HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DIRK
Authorized Official - Middle Name:J
Authorized Official - Last Name:BEUKES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:651-846-9597
Mailing Address - Street 1:901 COMO BLVD E
Mailing Address - Street 2:#118
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55103-1055
Mailing Address - Country:US
Mailing Address - Phone:651-846-9597
Mailing Address - Fax:651-846-9597
Practice Address - Street 1:901 COMO BLVD E
Practice Address - Street 2:#118
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55103-1055
Practice Address - Country:US
Practice Address - Phone:651-846-9597
Practice Address - Fax:651-846-9597
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-27
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health