Provider Demographics
NPI:1790156503
Name:SCANDINAVIAN HOMECARE LLC
Entity Type:Organization
Organization Name:SCANDINAVIAN HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR - OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:ALI
Authorized Official - Middle Name:
Authorized Official - Last Name:SAJJAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-702-3860
Mailing Address - Street 1:7400 METRO BLVD
Mailing Address - Street 2:SUITE # 155
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55439-2316
Mailing Address - Country:US
Mailing Address - Phone:952-222-9119
Mailing Address - Fax:
Practice Address - Street 1:7400 METRO BLVD
Practice Address - Street 2:SUITE # 155
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55439-2316
Practice Address - Country:US
Practice Address - Phone:952-222-9119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-20
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care