Healthcare Provider Details

I. General information

NPI: 1508308842
Provider Name (Legal Business Name): CARE PARTNERS HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2016
Last Update Date: 11/01/2021
Certification Date: 11/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8525 EDINBROOK XING STE 13
BROOKLYN PARK MN
55443-1967
US

IV. Provider business mailing address

8525 EDINBROOK XING STE 13
BROOKLYN PARK MN
55443-1967
US

V. Phone/Fax

Practice location:
  • Phone: 763-458-2727
  • Fax: 763-207-0076
Mailing address:
  • Phone: 763-458-2727
  • Fax: 763-207-0076

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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: ISHMAEL KOMARA
Title or Position: EXECUTIVE DIRECTOR
Credential: RN
Phone: 763-458-2727