Provider Demographics
NPI:1740575430
Name:NORTHEAST HOME HEALTH CARE, LLC
Entity Type:Organization
Organization Name:NORTHEAST HOME HEALTH CARE, LLC
Other - Org Name:N/A
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FARAH
Authorized Official - Middle Name:MOHAMED
Authorized Official - Last Name:ABDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-255-5041
Mailing Address - Street 1:1101 EUCLID
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64127-1152
Mailing Address - Country:US
Mailing Address - Phone:816-255-5041
Mailing Address - Fax:816-255-5041
Practice Address - Street 1:1101 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64127-1152
Practice Address - Country:US
Practice Address - Phone:816-255-5041
Practice Address - Fax:816-255-5041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-10
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOLC1122887251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health