Healthcare Provider Details

I. General information

NPI: 1437079092
Provider Name (Legal Business Name): NYONGUO HOME HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8660 MARYLAND CT N
BROOKLYN PARK MN
55445-2664
US

IV. Provider business mailing address

8660 MARYLAND CT N
BROOKLYN PARK MN
55445-2664
US

V. Phone/Fax

Practice location:
  • Phone: 240-644-2959
  • Fax:
Mailing address:
  • Phone: 240-644-2959
  • 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: SIMON NYONGUO
Title or Position: CEO
Credential:
Phone: 240-644-2959