Provider Demographics
NPI:1184197253
Name:JOURNEYS HOME CARE LLC
Entity Type:Organization
Organization Name:JOURNEYS HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NWAEMELE
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:NDUBISI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-202-4007
Mailing Address - Street 1:10157 GEORGIA AVE N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55445-2670
Mailing Address - Country:US
Mailing Address - Phone:612-202-4007
Mailing Address - Fax:763-425-4939
Practice Address - Street 1:5312 QUEEN AVE N
Practice Address - Street 2:
Practice Address - City:BROOKLYN CENTER
Practice Address - State:MN
Practice Address - Zip Code:55430-2946
Practice Address - Country:US
Practice Address - Phone:612-202-4007
Practice Address - Fax:763-425-4939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-10
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty