Provider Demographics
NPI:1861851545
Name:ACCESS HOME HEALTH SERVICE, INC
Entity Type:Organization
Organization Name:ACCESS HOME HEALTH SERVICE, INC
Other - Org Name:N/A
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:ALI
Authorized Official - Last Name:ABDIRAHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-404-5058
Mailing Address - Street 1:393 DUNLAP ST N STE 400K
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-4235
Mailing Address - Country:US
Mailing Address - Phone:612-404-5058
Mailing Address - Fax:651-925-0359
Practice Address - Street 1:393 DUNLAP ST N STE 400K
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-4235
Practice Address - Country:US
Practice Address - Phone:612-404-5058
Practice Address - Fax:651-925-0359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-23
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization