Provider Demographics
NPI:1811743826
Name:REDEEMING LOVE CARE CENTER HOME HEALTH AGENCY LLC
Entity type:Organization
Organization Name:REDEEMING LOVE CARE CENTER HOME HEALTH AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HIRUT
Authorized Official - Middle Name:
Authorized Official - Last Name:BERHANE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:612-386-5560
Mailing Address - Street 1:4730 102ND TRL N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55443-2064
Mailing Address - Country:US
Mailing Address - Phone:612-386-5560
Mailing Address - Fax:612-233-0040
Practice Address - Street 1:4730 102ND TRL N
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55443-2064
Practice Address - Country:US
Practice Address - Phone:612-386-5560
Practice Address - Fax:612-233-0040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-29
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty