Provider Demographics
NPI:1730466533
Name:DEPENDABLE HOME HEALTHCARE, INC
Entity Type:Organization
Organization Name:DEPENDABLE HOME HEALTHCARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMNISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:KWESI
Authorized Official - Last Name:MENSAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-779-9810
Mailing Address - Street 1:2984 RICE ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE CANADA
Mailing Address - State:MN
Mailing Address - Zip Code:55113-2230
Mailing Address - Country:US
Mailing Address - Phone:651-779-9810
Mailing Address - Fax:651-779-9809
Practice Address - Street 1:2984 RICE ST
Practice Address - Street 2:
Practice Address - City:LITTLE CANADA
Practice Address - State:MN
Practice Address - Zip Code:55113-2230
Practice Address - Country:US
Practice Address - Phone:651-779-9810
Practice Address - Fax:651-779-9809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-08
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNA7973454003104A0630X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNA797345400OtherMINNESOTA HEALTHCARE PROGRAMS