Provider Demographics
NPI:1437325958
Name:TRANS HOME CARE SERVICES
Entity Type:Organization
Organization Name:TRANS HOME CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FOLY
Authorized Official - Middle Name:BABATUNDE
Authorized Official - Last Name:COKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-561-1224
Mailing Address - Street 1:6500 BROOKLYN BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55429-1754
Mailing Address - Country:US
Mailing Address - Phone:763-561-1224
Mailing Address - Fax:763-503-9451
Practice Address - Street 1:517 KIMBALL ST NE
Practice Address - Street 2:
Practice Address - City:FRIDLEY
Practice Address - State:MN
Practice Address - Zip Code:55432-1642
Practice Address - Country:US
Practice Address - Phone:763-780-2842
Practice Address - Fax:763-503-9451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN339804251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN744668100Medicaid