Provider Demographics
NPI:1669646816
Name:COMPLETE HOME HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:COMPLETE HOME HEALTH SERVICES LLC
Other - Org Name:CADDY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:SIRRI
Authorized Official - Middle Name:A
Authorized Official - Last Name:NOMO-ONGOLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-788-2273
Mailing Address - Street 1:3616 ROOSEVELT ST NE
Mailing Address - Street 2:
Mailing Address - City:ST ANTHONY
Mailing Address - State:MN
Mailing Address - Zip Code:55418-1559
Mailing Address - Country:US
Mailing Address - Phone:612-788-2273
Mailing Address - Fax:
Practice Address - Street 1:3616 ROOSEVELT ST NE
Practice Address - Street 2:
Practice Address - City:ST ANTHONY
Practice Address - State:MN
Practice Address - Zip Code:55418-1559
Practice Address - Country:US
Practice Address - Phone:612-788-2273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMPLETE HOME HEALTH SERVICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-18
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health