Healthcare Provider Details

I. General information

NPI: 1053939397
Provider Name (Legal Business Name): ALPHA QUALITY CARE1 L. L. C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2020
Last Update Date: 06/09/2022
Certification Date: 06/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 E 146TH ST STE 107
BURNSVILLE MN
55337-6756
US

IV. Provider business mailing address

1020 E 146TH ST STE 107
BURNSVILLE MN
55337-6756
US

V. Phone/Fax

Practice location:
  • Phone: 612-483-8529
  • Fax:
Mailing address:
  • Phone: 612-483-8529
  • 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 Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State

VIII. Authorized Official

Name: MAHAD ABDULLAHI HASSAN
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 612-483-8529