Provider Demographics
NPI:1821209693
Name:COMPLETE HOME HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:COMPLETE HOME HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ADE
Authorized Official - Middle Name:F
Authorized Official - Last Name:NOMO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-788-2273
Mailing Address - Street 1:3616 ROOSEVELT ST NE
Mailing Address - Street 2:
Mailing Address - City:ST ANTHONY VILLAGE
Mailing Address - State:MN
Mailing Address - Zip Code:55418-1559
Mailing Address - Country:US
Mailing Address - Phone:612-788-2273
Mailing Address - Fax:
Practice Address - Street 1:4001 STINSON BLVD NE
Practice Address - Street 2:SUITE 223
Practice Address - City:ST ANTHONY VILLAGE
Practice Address - State:MN
Practice Address - Zip Code:55421-3497
Practice Address - Country:US
Practice Address - Phone:612-788-2273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8595915251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health