Provider Demographics
NPI:1710177837
Name:YOUNG HEARTS HOME HEALTH CARE
Entity Type:Organization
Organization Name:YOUNG HEARTS HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:SAINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-201-9586
Mailing Address - Street 1:5747 W BROADWAY AVE
Mailing Address - Street 2:120
Mailing Address - City:CRYSTAL
Mailing Address - State:MN
Mailing Address - Zip Code:55428-3572
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5747 W BROADWAY AVE
Practice Address - Street 2:120
Practice Address - City:CRYSTAL
Practice Address - State:MN
Practice Address - Zip Code:55428-3572
Practice Address - Country:US
Practice Address - Phone:763-201-9586
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-25
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN334089251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health