Healthcare Provider Details

I. General information

NPI: 1588557391
Provider Name (Legal Business Name): SIMBAL HEALTHCARE SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2025
Last Update Date: 05/30/2025
Certification Date: 05/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10420 PALM ST NW
COON RAPIDS MN
55433-4965
US

IV. Provider business mailing address

10420 PALM ST NW
COON RAPIDS MN
55433-4965
US

V. Phone/Fax

Practice location:
  • Phone: 804-309-0442
  • Fax:
Mailing address:
  • Phone: 804-309-0442
  • 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: ADEBOLA BALOGUN
Title or Position: CEO
Credential:
Phone: 804-309-0442