Provider Demographics
NPI:1407575954
Name:EMMANUEL HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:EMMANUEL HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GEMECHIS
Authorized Official - Middle Name:G
Authorized Official - Last Name:GUJA
Authorized Official - Suffix:
Authorized Official - Credentials:RN, PHN
Authorized Official - Phone:952-923-6581
Mailing Address - Street 1:2244 118TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:55449-5443
Mailing Address - Country:US
Mailing Address - Phone:952-923-6581
Mailing Address - Fax:
Practice Address - Street 1:7671 CENTRAL AVE NE STE 201
Practice Address - Street 2:
Practice Address - City:FRIDLEY
Practice Address - State:MN
Practice Address - Zip Code:55432-3542
Practice Address - Country:US
Practice Address - Phone:763-316-4892
Practice Address - Fax:833-312-0108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-26
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty