Provider Demographics
NPI:1245614015
Name:COMMUNITY HEALTH CARE LLC
Entity Type:Organization
Organization Name:COMMUNITY HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DYIR
Authorized Official - Middle Name:B
Authorized Official - Last Name:ABDI
Authorized Official - Suffix:
Authorized Official - Credentials:ETC
Authorized Official - Phone:612-407-4487
Mailing Address - Street 1:343 E LAKE ST
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-2455
Mailing Address - Country:US
Mailing Address - Phone:612-407-4487
Mailing Address - Fax:
Practice Address - Street 1:343 E LAKE ST
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408-2455
Practice Address - Country:US
Practice Address - Phone:612-407-4487
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-11
Last Update Date:2015-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health