Provider Demographics
NPI:1427842517
Name:PATRICIA HEALTH CARE LLC
Entity type:Organization
Organization Name:PATRICIA HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:OKHAE
Authorized Official - Last Name:OTIEMORIA
Authorized Official - Suffix:
Authorized Official - Credentials:BSC
Authorized Official - Phone:929-304-5215
Mailing Address - Street 1:5513 BROOKDALE DR N APT 312
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55443-3063
Mailing Address - Country:US
Mailing Address - Phone:929-304-5215
Mailing Address - Fax:
Practice Address - Street 1:5513 BROOKDALE DR N APT 312
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55443-3063
Practice Address - Country:US
Practice Address - Phone:929-304-5215
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PATRICIA HEALTH CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-04-05
Last Update Date:2025-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care