TEQUILA BUCKHANON (NPI# 1477170777) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477170777 |
| Entity Type | Individual |
| Full Name | TEQUILA BUCKHANON |
| Practice Address |
5701 Shingle Creek Pkwy Ste 250h Brooklyn Center MN 55430-2344 |
| Practice Telephone | 6126955614 |
| Enumeration Date | 2020-07-02 |
| Last Update Date | 2020-07-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | 10827598 | MN | Agencies |
| N | 343900000X | Non-emergency Medical Transport (VAN) | Transportation Services |
| Street Address |
5701 SHINGLE CREEK PKWY STE 250H |
| City | BROOKLYN CENTER |
| State | MN |
| Zip Code | 55430-2344 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396362182 | Graceland Homes | Home Health | 6843 Colfax Ave N, Brooklyn Center, MN 55430 | 2020-06-29 |
| 1912549742 | His Services Home Care, LLC | Home Health | 2108 70th Avenue North, Brooklyn Park, MN 55430 | 2019-10-14 |
| 1336612969 | Jeremiah Sk Pojah Sr. | Registered Nurse | 5201 Bryant Avenue North, Suite 108, Minneapolis, MN 55430 | 2019-01-07 |
| 1891219697 | Tamika Yvette Spicer | Home Health Aide | 6640 Humboldt Ave N, 101, Brooklyn Center, MN 55430 | 2017-08-02 |
| 1265973358 | James Contois | Community Based Residential Treatment Facility, Mental Illness | 6120 Earle Brown Drive, Suite 100, Brooklyn Center, MN 55430 | 2017-03-09 |
| 1336693746 | Sara Jean Cooper | Dentist | 1090 Shingle Creek Pkwy, Brooklyn Center, MN 55430 | 2016-08-15 |
| 1750732202 | Miriam Home Health Corporation | Residential Treatment Facility, Physical Disabilities | 7030 Humboldt Avenue North, Brooklyn Center, MN 55430 | 2016-06-27 |
| 1649628561 | Tranquility Health LLC | Community/Behavioral Health | 6040 Earle Brown Dr Ste 250, Brooklyn Center, MN 55430 | 2016-06-01 |
| 1104233790 | Lillie's Helping Hands | In Home Supportive Care | 6407 Camden Ave N, #303, Brooklyn Center, MN 55430 | 2014-07-16 |
| 1063760817 | Wal-mart Stores Inc | Technician/Technologist | 1200 Shingle Creek Crossing, Brooklyn Center, MN 55430 | 2012-08-28 |
| Find all providers in zip 55430 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| 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. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801493721 | Shifaa Care Inc | Home Health | 7038 Brooklyn Blvd Unit D, Brooklyn Center, MN 55429-1370 | 2020-10-04 |
| 1104436294 | Harmony Care Providers LLC | Home Health | 3101 68th Ave N, Brooklyn Center, MN 55429-4218 | 2020-08-04 |
| 1396362182 | Graceland Homes | Home Health | 6843 Colfax Ave N, Brooklyn Center, MN 55430 | 2020-06-29 |
| 1366067746 | Vision2020 Group Homes LLC | Home Health | 411 70th Ave N Apt 213, Brooklyn Center, MN 55430-1244 | 2020-06-11 |
| 1578187316 | Resilience Care Services LLC | Home Health | 5352 Emerson Ave N, Brooklyn Center, MN 55430-3130 | 2020-06-06 |
| 1326662925 | Harmony Homes LLC | Home Health | 7006 Morgan Ave N, Brooklyn Center, MN 55430-1031 | 2020-05-31 |
| 1245852979 | Comfort Home Care | Home Health | 5950 Beard Ave N, Brooklyn Center, MN 55429 | 2020-05-15 |
| 1982226262 | 4 Abc Home Care Services | Home Health | 3300 County Road 10 Ste 320d, Brooklyn Center, MN 55429-3072 | 2020-05-10 |
| 1932729878 | New Hope Health Care LLC | Home Health | 3812 Bass Lake Rd, Brooklyn Center, MN 55429-3005 | 2020-04-21 |
| 1083254684 | Love & Care LLC | Home Health | 5324 Boulder Ln, Brooklyn Center, MN 55429-2305 | 2020-01-10 |
| Find all providers in BROOKLYN CENTER | ||||
| City | BROOKLYN CENTER |
| Zip Code | 55430 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.