Healthcare Provider Details

I. General information

NPI: 1376794396
Provider Name (Legal Business Name): ARMS OF COMPASSION HOME CARE SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2008
Last Update Date: 10/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3825 51ST AVE N
BROOKLYN CENTER MN
55429-3368
US

IV. Provider business mailing address

3825 51ST AVE N
BROOKLYN CENTER MN
55429-3368
US

V. Phone/Fax

Practice location:
  • Phone: 612-408-8433
  • Fax: 612-659-1499
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: KECIA CANNON
Title or Position: OWNER
Credential:
Phone: 612-408-3433