MEDICARE: TOTAL HOME HEALTH CARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1144609728
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOTAL HOME HEALTH CARE, LLC

Provider Business Mailing Address
First Line	:	3318 E LAKE ST STE A
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55406-2077
Country	:	US
Telephone Number	:	612-437-4767
Fax Number	:

Provider Business Practice Location Address
First Line	:	3318 E L:AKE ST SUITE A
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55406-1760
Country	:	US
Telephone Number	:	612-644-0026
Fax Number	:	612-437-4767

Authorized Official
Title or Position	:	OWNER
Name	:	MR. MOHAMED SAID WARSAME
Credential	:
Telephone Number	:	612-644-0026

Provider Enumeration Date	:	05/28/2015
Last Update Date	:	03/05/2019

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