Provider Demographics
NPI:1508381047
Name:MINNESOTA HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:MINNESOTA HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ABDIWELI
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHAMUD
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:612-940-9829
Mailing Address - Street 1:534 HUSET PKWY NE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55421-5030
Mailing Address - Country:US
Mailing Address - Phone:612-940-9829
Mailing Address - Fax:
Practice Address - Street 1:534 HUSET PARKWAY
Practice Address - Street 2:
Practice Address - City:COLUMBIA HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55421
Practice Address - Country:US
Practice Address - Phone:612-940-9829
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health