Healthcare Provider Details

I. General information

NPI: 1982944104
Provider Name (Legal Business Name): PREFERRED CHOICE HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2013
Last Update Date: 02/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7668 150TH ST W SUITE 202
APPLE VALLEY MN
55124-7193
US

IV. Provider business mailing address

7668 150TH ST W SUITE 202
APPLE VALLEY MN
55124-7193
US

V. Phone/Fax

Practice location:
  • Phone: 952-997-4344
  • Fax: 952-997-4347
Mailing address:
  • Phone: 952-997-4344
  • Fax: 952-997-4347

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: AHMED ABDIRAHMAN MUHUMUD
Title or Position: MANAGER
Credential:
Phone: 952-997-4344