Healthcare Provider Details

I. General information

NPI: 1225542608
Provider Name (Legal Business Name): ALL HOPES INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2017
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9937 LINNET ST NW
COON RAPIDS MN
55433-4721
US

IV. Provider business mailing address

5549 VINEWOOD LN N
PLYMOUTH MN
55442-1737
US

V. Phone/Fax

Practice location:
  • Phone: 763-482-1487
  • Fax: 763-951-2775
Mailing address:
  • Phone: 763-482-1487
  • Fax: 763-577-4160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: VICTOR AWOSIKA
Title or Position: ADMINISTRATOR
Credential:
Phone: 763-482-1487