Provider Demographics
NPI:1659267896
Name:EMS HOLISTIC NURSING HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:EMS HOLISTIC NURSING HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:OLUFUNMILOLA
Authorized Official - Last Name:ROTIMI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:763-291-2383
Mailing Address - Street 1:926 SPANCIL HILL DR
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55129-5531
Mailing Address - Country:US
Mailing Address - Phone:763-291-2383
Mailing Address - Fax:
Practice Address - Street 1:926 SPANCIL HILL DR
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55129-5531
Practice Address - Country:US
Practice Address - Phone:763-291-2383
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health