Provider Demographics
NPI:1568020873
Name:CHOICE CARE HOMES LLC
Entity Type:Organization
Organization Name:CHOICE CARE HOMES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NIMO
Authorized Official - Middle Name:ABDUKADIR
Authorized Official - Last Name:SHEIKHYUSSUF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-644-0473
Mailing Address - Street 1:446 SHERBURNE AVE UNIT A
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55103-1943
Mailing Address - Country:US
Mailing Address - Phone:612-644-0473
Mailing Address - Fax:
Practice Address - Street 1:446 SHERBURNE AVE UNIT A
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55103-5510
Practice Address - Country:US
Practice Address - Phone:612-644-0473
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-01
Last Update Date:2019-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care