Provider Demographics
NPI:1093972440
Name:ENOCK HOMECARE ASSISTANCE, LLC
Entity Type:Organization
Organization Name:ENOCK HOMECARE ASSISTANCE, LLC
Other - Org Name:VISITING ANGELS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:NAMUKULO
Authorized Official - Middle Name:
Authorized Official - Last Name:AKAKULU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-233-5600
Mailing Address - Street 1:100 FULLER ST S STE 220
Mailing Address - Street 2:
Mailing Address - City:SHAKOPEE
Mailing Address - State:MN
Mailing Address - Zip Code:55379-1354
Mailing Address - Country:US
Mailing Address - Phone:952-233-5600
Mailing Address - Fax:952-233-3226
Practice Address - Street 1:100 FULLER ST S STE 220
Practice Address - Street 2:
Practice Address - City:SHAKOPEE
Practice Address - State:MN
Practice Address - Zip Code:55379-1354
Practice Address - Country:US
Practice Address - Phone:952-233-5600
Practice Address - Fax:952-233-3226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN339797251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health