Provider Demographics
NPI:1275075434
Name:BALSAM HOME CARE INC
Entity Type:Organization
Organization Name:BALSAM HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OMAR
Authorized Official - Middle Name:S
Authorized Official - Last Name:ASAMARAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-999-5515
Mailing Address - Street 1:3029 CAREY HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55109-5529
Mailing Address - Country:US
Mailing Address - Phone:612-999-5515
Mailing Address - Fax:612-568-9507
Practice Address - Street 1:3029 CAREY HEIGHTS DR
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-5529
Practice Address - Country:US
Practice Address - Phone:612-999-5515
Practice Address - Fax:612-568-9507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-04
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care