Provider Demographics
NPI:1851051049
Name:MINNESOTA HEALTH HOMECARE LLC
Entity Type:Organization
Organization Name:MINNESOTA HEALTH HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN/CEO
Authorized Official - Prefix:
Authorized Official - First Name:AYUB
Authorized Official - Middle Name:
Authorized Official - Last Name:ONKUNDI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:612-414-2067
Mailing Address - Street 1:169 91ST AVE NE
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:55434-1133
Mailing Address - Country:US
Mailing Address - Phone:612-414-2067
Mailing Address - Fax:
Practice Address - Street 1:169 91ST AVE NE
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55434-1133
Practice Address - Country:US
Practice Address - Phone:612-414-2067
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-29
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health