Provider Demographics
NPI:1780460402
Name:SHEBAH HOME HEALTH CARE
Entity type:Organization
Organization Name:SHEBAH HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TSHILANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MUTAMBA
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN
Authorized Official - Phone:651-354-1230
Mailing Address - Street 1:PO BOX 98
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MN
Mailing Address - Zip Code:55304-0010
Mailing Address - Country:US
Mailing Address - Phone:651-354-1230
Mailing Address - Fax:
Practice Address - Street 1:3224 139TH AVE NW
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MN
Practice Address - Zip Code:55304-7539
Practice Address - Country:US
Practice Address - Phone:651-354-1230
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty
No251E00000XAgenciesHome HealthGroup - Single Specialty
No251J00000XAgenciesNursing Care