Provider Demographics
NPI:1225118342
Name:TAYO HOME HEALTH CARE
Entity Type:Organization
Organization Name:TAYO HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDEN
Authorized Official - Prefix:MR
Authorized Official - First Name:ALI
Authorized Official - Middle Name:ABDI
Authorized Official - Last Name:JAMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-871-6328
Mailing Address - Street 1:2 E FRANKLIN SUITE 9
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-2558
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2 E FRANKLIN AVE STE 9
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-2558
Practice Address - Country:US
Practice Address - Phone:612-871-6328
Practice Address - Fax:612-874-0454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN329379302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN4980501OtherMEDICA PROVIDER NUMBER
MN428954400OtherMHCP PROVIDER NUMBER