Provider Demographics
NPI:1093567885
Name:WILLOW HOME CARE INC
Entity Type:Organization
Organization Name:WILLOW HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HAMDI
Authorized Official - Middle Name:
Authorized Official - Last Name:HUSSEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-359-4890
Mailing Address - Street 1:3918 CENTRAL AVE NE STE B
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55421-3931
Mailing Address - Country:US
Mailing Address - Phone:651-359-4890
Mailing Address - Fax:
Practice Address - Street 1:3918 CENTRAL AVE NE STE B
Practice Address - Street 2:
Practice Address - City:COLUMBIA HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55421-3931
Practice Address - Country:US
Practice Address - Phone:651-359-4890
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health