Provider Demographics
NPI:1801178983
Name:SEFERTT HEALTH CARE LLC
Entity Type:Organization
Organization Name:SEFERTT HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MATHEW
Authorized Official - Middle Name:OLUSAKIN
Authorized Official - Last Name:AMUSAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:651-278-1144
Mailing Address - Street 1:3621 85TH AVE N
Mailing Address - Street 2:SUITE 103
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55443-1931
Mailing Address - Country:US
Mailing Address - Phone:651-278-1144
Mailing Address - Fax:763-657-7537
Practice Address - Street 1:3621 85TH AVE N
Practice Address - Street 2:SUITE 103
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55443-1931
Practice Address - Country:US
Practice Address - Phone:651-278-1144
Practice Address - Fax:763-657-7537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-14
Last Update Date:2015-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN353744251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health