Provider Demographics
NPI:1336479104
Name:SAJO HOME CARE SERVICES INC.
Entity Type:Organization
Organization Name:SAJO HOME CARE SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:JOKOTOLA
Authorized Official - Last Name:ADEJUWON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:763-424-2184
Mailing Address - Street 1:9007 IDAHO AVE N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55445-3215
Mailing Address - Country:US
Mailing Address - Phone:763-424-2184
Mailing Address - Fax:952-583-1065
Practice Address - Street 1:9007 IDAHO AVE N
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55445-3215
Practice Address - Country:US
Practice Address - Phone:763-424-2184
Practice Address - Fax:952-583-1065
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PARENT ORGANIZATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-12-30
Last Update Date:2009-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN342984251T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization