Healthcare Provider Details

I. General information

NPI: 1629737382
Provider Name (Legal Business Name): TWINS HOME CARE SERVICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2021
Last Update Date: 12/09/2021
Certification Date: 12/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13708 WELLINGTON CRES
BURNSVILLE MN
55337-4337
US

IV. Provider business mailing address

13708 WELLINGTON CRES
BURNSVILLE MN
55337-4337
US

V. Phone/Fax

Practice location:
  • Phone: 952-484-2758
  • Fax:
Mailing address:
  • Phone: 952-484-2758
  • 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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: NAOD TEZERA
Title or Position: OWNER
Credential:
Phone: 952-484-2758