Healthcare Provider Details

I. General information

NPI: 1760399034
Provider Name (Legal Business Name): MUADA HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39326 N OCOTILLO RIDGE DR
CAREFREE AZ
85377-4476
US

IV. Provider business mailing address

7202 114TH AVE N
CHAMPLIN MN
55316-2898
US

V. Phone/Fax

Practice location:
  • Phone: 612-423-6247
  • Fax:
Mailing address:
  • Phone: 612-423-6247
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: PERPETUAL LOVE GARYEAZON
Title or Position: OWNER/CNA
Credential: GARYEAZON
Phone: 612-423-6247