Provider Demographics
NPI:1902915606
Name:HOME FREE INCORPORATED
Entity Type:Organization
Organization Name:HOME FREE INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL OFFICER/ OWNERS
Authorized Official - Prefix:MR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:LAURENCE
Authorized Official - Last Name:WALTERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-814-7400
Mailing Address - Street 1:PO BOX 20102
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55420-0102
Mailing Address - Country:US
Mailing Address - Phone:952-814-7400
Mailing Address - Fax:952-853-0966
Practice Address - Street 1:8100 26TH AVE S
Practice Address - Street 2:SUITE 165
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55425-1310
Practice Address - Country:US
Practice Address - Phone:952-814-7400
Practice Address - Fax:952-853-0966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health