Provider Demographics
NPI:1649792151
Name:HELIOPOLIS HOME HEALTHCARE LLC
Entity type:Organization
Organization Name:HELIOPOLIS HOME HEALTHCARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:NURULDIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:H NUR
Authorized Official - Suffix:
Authorized Official - Credentials:MPA,
Authorized Official - Phone:612-644-8696
Mailing Address - Street 1:2522 CENTRAL AVE NE STE 204
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55418-3726
Mailing Address - Country:US
Mailing Address - Phone:651-347-5334
Mailing Address - Fax:
Practice Address - Street 1:2522 CENTRAL AVE NE STE 204
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55418-3726
Practice Address - Country:US
Practice Address - Phone:651-347-5334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN381417251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN381417OtherMINNESOTA DEPARTMENT OF HEALTH