MEDICARE: TRUSTED HOME CARE, LLC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251E00000X	Home Health Agency
2	261QA0600X	Adult Day Care Clinic/Center
3	311Z00000X	Custodial Care Facility
4	251J00000X	Nursing Care Agency

General Provider Information

NPI Number	:	1952623852
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRUSTED HOME CARE, LLC.

Provider Business Mailing Address
First Line	:	5821 CEDAR LAKE RD S UNIT H-204
Second Line	:
City	:	SAINT LOUIS PARK
State	:	MN
Zip	:	55416-1487
Country	:	US
Telephone Number	:	952-378-1592
Fax Number	:	952-378-2878

Provider Business Practice Location Address
First Line	:	5821 CEDAR LAKE RD S UNIT H-204
Second Line	:
City	:	SAINT LOUIS PARK
State	:	MN
Zip	:	55416-1487
Country	:	US
Telephone Number	:	952-378-1592
Fax Number	:	952-378-2878

Authorized Official
Title or Position	:	RN-MANAGING EMPLOYEE/CO-OWNER
Name	:	MR. GOODIE O ILUEBBEY
Credential	:	RN
Telephone Number	:	763-221-4774

Provider Enumeration Date	:	02/18/2010
Last Update Date	:	10/10/2024

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Directions to “TRUSTED HOME CARE, LLC. ” Practice Location

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