Provider Demographics
NPI:1538552757
Name:ABODE HOSPICE AND HOMECARE OF MN, LLC
Entity type:Organization
Organization Name:ABODE HOSPICE AND HOMECARE OF MN, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:KOEPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-828-2210
Mailing Address - Street 1:1811 WEIR DR STE 150
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-2254
Mailing Address - Country:US
Mailing Address - Phone:651-344-1040
Mailing Address - Fax:651-347-6904
Practice Address - Street 1:1811 WEIR DR STE 150
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-2254
Practice Address - Country:US
Practice Address - Phone:651-344-1040
Practice Address - Fax:651-347-6904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-12
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based