Provider Demographics
NPI:1568780278
Name:ROCHESTER HOME CARE
Entity Type:Organization
Organization Name:ROCHESTER HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ABDULLAHI
Authorized Official - Middle Name:ABDI
Authorized Official - Last Name:HUSSEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-205-9326
Mailing Address - Street 1:1504 VALLEYHIGH DR NW
Mailing Address - Street 2:3
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-0738
Mailing Address - Country:US
Mailing Address - Phone:612-205-9326
Mailing Address - Fax:
Practice Address - Street 1:1504 VALLEYHIGH DR NW
Practice Address - Street 2:3
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-0738
Practice Address - Country:US
Practice Address - Phone:612-205-9326
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-06
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3688143-2253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care