Provider Demographics
NPI:1720637549
Name:CHARM HOME CARE LLC
Entity Type:Organization
Organization Name:CHARM HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABDIKERM
Authorized Official - Middle Name:A
Authorized Official - Last Name:EIDLEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-323-2240
Mailing Address - Street 1:3249 HENNEPIN AVE STE 75
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-3410
Mailing Address - Country:US
Mailing Address - Phone:612-367-4394
Mailing Address - Fax:612-500-4277
Practice Address - Street 1:3249 HENNEPIN AVE STE 75
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408-3410
Practice Address - Country:US
Practice Address - Phone:612-367-4394
Practice Address - Fax:612-500-4277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-04
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care