Provider Demographics
NPI:1518673417
Name:ASSOCIATE HEALTHCARE LLC
Entity Type:Organization
Organization Name:ASSOCIATE HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YERO
Authorized Official - Middle Name:
Authorized Official - Last Name:JALLOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-378-3166
Mailing Address - Street 1:3308 74TH CIR N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55443-3517
Mailing Address - Country:US
Mailing Address - Phone:612-378-3166
Mailing Address - Fax:
Practice Address - Street 1:3308 74TH CIR N
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55443-3517
Practice Address - Country:US
Practice Address - Phone:612-378-3166
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-25
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility