Provider Demographics
NPI:1194156034
Name:SHERON HOME HEALTH CARE, LLC
Entity type:Organization
Organization Name:SHERON HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:C
Authorized Official - Last Name:GLYNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-413-1235
Mailing Address - Street 1:2480 HIGHWAY 100 S
Mailing Address - Street 2:APT 132
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-1762
Mailing Address - Country:US
Mailing Address - Phone:731-413-1235
Mailing Address - Fax:
Practice Address - Street 1:2480 HIGHWAY 100 S
Practice Address - Street 2:APT 132
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-1762
Practice Address - Country:US
Practice Address - Phone:731-413-1235
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-03
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility