Provider Demographics
NPI:1760870810
Name:TWIN CITY HOME HEALTHCARE, LLC
Entity Type:Organization
Organization Name:TWIN CITY HOME HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDULLAHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-232-3297
Mailing Address - Street 1:620 16TH AVE S STE 45
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55454-1118
Mailing Address - Country:US
Mailing Address - Phone:612-232-3297
Mailing Address - Fax:
Practice Address - Street 1:620 16TH AVE S STE 45
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55454-1118
Practice Address - Country:US
Practice Address - Phone:612-232-3297
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-23
Last Update Date:2014-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN367252251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNA165197100Medicaid