Provider Demographics
NPI:1265202824
Name:ADAM HOME HEALTHCARE, LLC
Entity type:Organization
Organization Name:ADAM HOME HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:
Authorized Official - First Name:TAHER
Authorized Official - Middle Name:A
Authorized Official - Last Name:MOHAMED
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE
Authorized Official - Phone:176-361-4647
Mailing Address - Street 1:464 DOGWOOD CT NW
Mailing Address - Street 2:
Mailing Address - City:SAINT MICHAEL
Mailing Address - State:MN
Mailing Address - Zip Code:55376-1020
Mailing Address - Country:US
Mailing Address - Phone:176-361-4647
Mailing Address - Fax:
Practice Address - Street 1:464 DOGWOOD CT NW
Practice Address - Street 2:
Practice Address - City:SAINT MICHAEL
Practice Address - State:MN
Practice Address - Zip Code:55376-1020
Practice Address - Country:US
Practice Address - Phone:176-361-4647
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-04
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health