Provider Demographics
NPI:1518550532
Name:ALL HOME CARE LLC
Entity Type:Organization
Organization Name:ALL HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ABDIRISAK
Authorized Official - Middle Name:DAYIB
Authorized Official - Last Name:HASSAN
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:763-291-4054
Mailing Address - Street 1:2525 E FRANKLIN AVE STE 280
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55406-1265
Mailing Address - Country:US
Mailing Address - Phone:763-291-4054
Mailing Address - Fax:612-455-2185
Practice Address - Street 1:2525 E FRANKLIN AVE STE 280
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55406-1265
Practice Address - Country:US
Practice Address - Phone:763-291-4054
Practice Address - Fax:612-455-2185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-19
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN6525185Medicaid