Provider Demographics
NPI:1699516831
Name:ACCOLADE HOME HEALTHCARE
Entity type:Organization
Organization Name:ACCOLADE HOME HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:LORETZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:651-492-9009
Mailing Address - Street 1:4830 AIRLAKE DR
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55129-5729
Mailing Address - Country:US
Mailing Address - Phone:651-492-9009
Mailing Address - Fax:
Practice Address - Street 1:4830 AIRLAKE DR
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55129-5729
Practice Address - Country:US
Practice Address - Phone:651-492-9009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health