Healthcare Provider Details

I. General information

NPI: 1508526005
Provider Name (Legal Business Name): HEALING HOLISTICALLY HOME HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2021
Last Update Date: 02/03/2025
Certification Date: 02/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11872 EMERY VILLAGE DR N
CHAMPLIN MN
55316-2490
US

IV. Provider business mailing address

11872 EMERY VILLAGE DR N
CHAMPLIN MN
55316-2490
US

V. Phone/Fax

Practice location:
  • Phone: 952-688-8361
  • Fax:
Mailing address:
  • Phone: 952-688-8361
  • 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

VIII. Authorized Official

Name: NAKABINGA NAMOONDE
Title or Position: OWNER
Credential:
Phone: 763-245-9366