Provider Demographics
NPI:1770816274
Name:IN CHARGE HOME HEALTHCARE SERVICE
Entity Type:Organization
Organization Name:IN CHARGE HOME HEALTHCARE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GELGELU
Authorized Official - Middle Name:
Authorized Official - Last Name:FELEMA
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:651-332-4220
Mailing Address - Street 1:413 CENTRAL AVE W
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55103-2219
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:413 CENTRAL AVE W
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55103-2219
Practice Address - Country:US
Practice Address - Phone:651-332-4220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-15
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3468804-2251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health