Provider Demographics
NPI:1376966655
Name:ASSURED HOMES, LLC
Entity Type:Organization
Organization Name:ASSURED HOMES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:AMOS
Authorized Official - Middle Name:S
Authorized Official - Last Name:OMBITO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-306-7293
Mailing Address - Street 1:8650 TESSMAN CIR N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55445-3101
Mailing Address - Country:US
Mailing Address - Phone:612-306-7293
Mailing Address - Fax:888-215-5070
Practice Address - Street 1:8650 TESSMAN CIR N
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55445-3101
Practice Address - Country:US
Practice Address - Phone:612-306-7293
Practice Address - Fax:888-215-5070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-22
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN364678251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health