Provider Demographics
NPI:1316383839
Name:VOLD LLC
Entity type:Organization
Organization Name:VOLD LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KALEB
Authorized Official - Middle Name:
Authorized Official - Last Name:VOLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-955-9881
Mailing Address - Street 1:15612 HIGHWAY 7
Mailing Address - Street 2:SUITE 210
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55345-3543
Mailing Address - Country:US
Mailing Address - Phone:952-955-9880
Mailing Address - Fax:888-483-7250
Practice Address - Street 1:15612 HIGHWAY 7
Practice Address - Street 2:SUITE 210
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55345-3543
Practice Address - Country:US
Practice Address - Phone:952-955-9880
Practice Address - Fax:888-483-7250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-13
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNHE-01084-04251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health