MEDICARE: INSPIRED HOME HEALTHCARE 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	251E00000X	Home Health Agency		MN

General Provider Information

NPI Number	:	1265883698
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INSPIRED HOME HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	2817 ANTHONY LN S STE 103
Second Line	:
City	:	ST ANTHONY
State	:	MN
Zip	:	55418-2489
Country	:	US
Telephone Number	:	612-701-2731
Fax Number	:	877-623-2009

Provider Business Practice Location Address
First Line	:	2817 ANTHONY LN S STE 103
Second Line	:
City	:	ST ANTHONY
State	:	MN
Zip	:	55418-2489
Country	:	US
Telephone Number	:	612-701-2731
Fax Number	:	877-623-2009

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	HASSAN HAJI-MOHAMUD
Credential	:
Telephone Number	:	612-701-2731

Provider Enumeration Date	:	06/27/2016
Last Update Date	:	02/06/2017

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