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Tequila Buckhanon
Home Health Agency in Brooklyn Center, Minnesota
NPI 1477170777

Tequila Buckhanon is a Home Health Agency based in Brooklyn Center, MN. Tequila Buckhanon practices in Brooklyn Center, MN. The NPI Number for Tequila Buckhanon is 1477170777 and holds a License No. (Minnesota).

The current practice location address for Tequila Buckhanon is 5701 Shingle Creek Pkwy Ste 250H, Brooklyn Center, MN and can be reached out via phone at 612-695-5614. You can also correspond with Tequila Buckhanon through the mailing address at 5701 SHINGLE CREEK PKWY STE 250H, BROOKLYN CENTER, MN - 55430-2344 (mailing address contact number: ).

Location: 5701 Shingle Creek Pkwy Ste 250H, Brooklyn Center, MN, 55430-2344
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1477170777
Provider Name
Tequila Buckhanon
Credential
Provider Entity Type
Individual
Gender
Female
Address
5701 Shingle Creek Pkwy Ste 250H, Brooklyn Center, MN, 55430-2344
Phone Number
612-695-5614
Fax Number
Provider Enumeration Date
07/02/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
5701 Shingle Creek Pkwy Ste 250H
City
Brooklyn Center
State
Minnesota
Zip
55430-2344
Phone Number
612-695-5614
Fax Number
person
Provider Business Mailing Address Details
Address
5701 Shingle Creek Pkwy Ste 250H
City
Brooklyn Center
State
Minnesota
Zip
55430-2344
Phone Number
612-695-5614
Fax Number
person
Provider's Taxonomy Details 1
Type
Agencies
Classification
Home Health
Speciality
-
Taxonomy
251E00000X
License No.
10827598 (Minnesota)
Definition
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.
person
Provider's Taxonomy Details 2
Type
Transportation Services
Classification
Non-emergency Medical Transport (VAN)
Speciality
-
Taxonomy
343900000X
License No.
()
Definition
A land vehicle with a capacity to meet special height, clearance, access, and seating, for the conveyance of persons in non-emergency situations. The vehicle may or may not be required to meet local county or state regulations.
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