Provider Demographics
NPI:1235675059
Name:HOME CARE SPECIALITY LLC
Entity Type:Organization
Organization Name:HOME CARE SPECIALITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELLA
Authorized Official - Middle Name:BWARI
Authorized Official - Last Name:ONYAMBU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-302-9930
Mailing Address - Street 1:901 TWELVE OAKS CENTER DR STE 914
Mailing Address - Street 2:
Mailing Address - City:WAYZATA
Mailing Address - State:MN
Mailing Address - Zip Code:55391-4710
Mailing Address - Country:US
Mailing Address - Phone:763-302-9930
Mailing Address - Fax:
Practice Address - Street 1:901 TWELVE OAKS CENTER DR
Practice Address - Street 2:# 914
Practice Address - City:WAYZATA
Practice Address - State:MN
Practice Address - Zip Code:55391-4701
Practice Address - Country:US
Practice Address - Phone:763-302-9930
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-18
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN379624251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health