Provider Demographics
NPI:1942609425
Name:AMERICAN HOME HEALTH AIDE LLC
Entity Type:Organization
Organization Name:AMERICAN HOME HEALTH AIDE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHERWA
Authorized Official - Middle Name:
Authorized Official - Last Name:NUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-452-2287
Mailing Address - Street 1:4651 NICOLS RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55122-3336
Mailing Address - Country:US
Mailing Address - Phone:651-452-2287
Mailing Address - Fax:651-454-8328
Practice Address - Street 1:4651 NICOLS RD
Practice Address - Street 2:SUITE 205
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-3336
Practice Address - Country:US
Practice Address - Phone:651-452-2287
Practice Address - Fax:651-454-8328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-20
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN367586251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health