Provider Demographics
NPI:1851770648
Name:VILLAGE HOME CARE LLC
Entity Type:Organization
Organization Name:VILLAGE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:OMAR
Authorized Official - Middle Name:MOHAMED
Authorized Official - Last Name:SAMATAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-666-5000
Mailing Address - Street 1:601 E 22ND ST
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-2853
Mailing Address - Country:US
Mailing Address - Phone:612-666-5000
Mailing Address - Fax:763-244-1001
Practice Address - Street 1:601 E 22ND ST
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-2853
Practice Address - Country:US
Practice Address - Phone:612-666-5000
Practice Address - Fax:763-244-1001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-26
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health