Healthcare Provider Details

I. General information

NPI: 1336876796
Provider Name (Legal Business Name): PERSONALIZED CARE FOR ALL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2022
Last Update Date: 08/05/2022
Certification Date: 08/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5972 CAHILL AVE STE 101
INVER GROVE HEIGHTS MN
55076-1521
US

IV. Provider business mailing address

5972 CAHILL AVE STE 101
INVER GROVE HEIGHTS MN
55076-1521
US

V. Phone/Fax

Practice location:
  • Phone: 651-478-6770
  • Fax: 651-478-6772
Mailing address:
  • Phone: 651-478-6770
  • Fax: 651-478-6772

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: AYAN YUSUF ISMAIL
Title or Position: OWNER
Credential:
Phone: 651-478-6770