Provider Demographics
NPI:1508308842
Name:CARE PARTNERS HOMECARE LLC
Entity Type:Organization
Organization Name:CARE PARTNERS HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ISHMAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KOMARA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:763-458-2727
Mailing Address - Street 1:8525 EDINBROOK XING STE 13
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55443-1967
Mailing Address - Country:US
Mailing Address - Phone:763-458-2727
Mailing Address - Fax:763-207-0076
Practice Address - Street 1:8525 EDINBROOK XING STE 13
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55443-1967
Practice Address - Country:US
Practice Address - Phone:763-458-2727
Practice Address - Fax:763-207-0076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-16
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN893113100022Medicaid