Provider Demographics
NPI:1184770257
Name:SO HOME HEALTHCARE, INC
Entity type:Organization
Organization Name:SO HOME HEALTHCARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:JO
Authorized Official - Last Name:LOVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-749-3318
Mailing Address - Street 1:3920 NICOLLET AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55409-1566
Mailing Address - Country:US
Mailing Address - Phone:612-749-3318
Mailing Address - Fax:612-822-3832
Practice Address - Street 1:3920 NICOLLET AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55409-1566
Practice Address - Country:US
Practice Address - Phone:612-749-3318
Practice Address - Fax:612-822-3832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies