Provider Demographics
NPI:1366816308
Name:BRIGHSTAR HOME HEALTH CARE INC.
Entity Type:Organization
Organization Name:BRIGHSTAR HOME HEALTH CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ILHAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:HUSSEIN
Authorized Official - Suffix:
Authorized Official - Credentials:BACHOLAR'S DEGREE
Authorized Official - Phone:612-221-1986
Mailing Address - Street 1:1808 RIVERSIDE AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55454-1121
Mailing Address - Country:US
Mailing Address - Phone:612-221-1986
Mailing Address - Fax:612-673-0379
Practice Address - Street 1:1808 RIVERSIDE AVE STE 205
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55454-1121
Practice Address - Country:US
Practice Address - Phone:612-221-1986
Practice Address - Fax:612-673-0379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-13
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN31934251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN31934OtherMINNESOTA DEPARTMENT OF HEALTH