Provider Demographics
NPI:1659515765
Name:HANNAH HOME INC
Entity Type:Organization
Organization Name:HANNAH HOME INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:GAYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-770-0696
Mailing Address - Street 1:8424 SUMTER AVE N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55445-2167
Mailing Address - Country:US
Mailing Address - Phone:612-770-0696
Mailing Address - Fax:763-493-2909
Practice Address - Street 1:8424 SUMTER AVE N
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55445-2167
Practice Address - Country:US
Practice Address - Phone:612-770-0696
Practice Address - Fax:763-493-2909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-21
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN799410900251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health