Provider Demographics
NPI:1699384131
Name:AMAZING HOME LLC
Entity Type:Organization
Organization Name:AMAZING HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RHODA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAPPOE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-432-6557
Mailing Address - Street 1:3220 COUNTY ROAD 10 STE 117
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN CTR
Mailing Address - State:MN
Mailing Address - Zip Code:55429-3073
Mailing Address - Country:US
Mailing Address - Phone:763-432-6557
Mailing Address - Fax:833-962-6144
Practice Address - Street 1:3220 COUNTY ROAD 10 STE 117
Practice Address - Street 2:
Practice Address - City:BROOKLYN CTR
Practice Address - State:MN
Practice Address - Zip Code:55429-3073
Practice Address - Country:US
Practice Address - Phone:763-432-6557
Practice Address - Fax:833-962-6144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-30
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty
No251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No251J00000XAgenciesNursing Care
No251S00000XAgenciesCommunity/Behavioral Health
No3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
No3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)
No385H00000XRespite Care FacilityRespite Care
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child