Provider Demographics
NPI:1699211839
Name:ABLE CARE HOME HEALTH LLC
Entity Type:Organization
Organization Name:ABLE CARE HOME HEALTH LLC
Other - Org Name:ABLE CARE HOME HEALTH LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NOU
Authorized Official - Middle Name:
Authorized Official - Last Name:VANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-501-2861
Mailing Address - Street 1:393 DUNLAP ST N STE 400E
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-4235
Mailing Address - Country:US
Mailing Address - Phone:651-644-1590
Mailing Address - Fax:
Practice Address - Street 1:393 DUNLAP ST N STE 400E
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-4235
Practice Address - Country:US
Practice Address - Phone:651-644-1590
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-11
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care