Provider Demographics
NPI:1467916205
Name:24 - SEVEN HOME CARE INC
Entity Type:Organization
Organization Name:24 - SEVEN HOME CARE INC
Other - Org Name:24 - SEVEN HOME CARE INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:OVIE
Authorized Official - Middle Name:
Authorized Official - Last Name:AVWENAGHAGHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-886-2828
Mailing Address - Street 1:7111 W BROADWAY AVE STE 202D
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55428-1692
Mailing Address - Country:US
Mailing Address - Phone:612-886-2828
Mailing Address - Fax:612-886-2861
Practice Address - Street 1:7111 W BROADWAY AVE STE 202D
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55428-1692
Practice Address - Country:US
Practice Address - Phone:612-886-2828
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-25
Last Update Date:2019-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No385H00000XRespite Care FacilityRespite Care