Healthcare Provider Details

I. General information

NPI: 1730084971
Provider Name (Legal Business Name): CEDAR HOME HEALTH SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

326 CEDAR AVE S APT 8
MINNEAPOLIS MN
55454-7504
US

IV. Provider business mailing address

326 CEDAR AVE S APT 8
MINNEAPOLIS MN
55454-7504
US

V. Phone/Fax

Practice location:
  • Phone: 612-400-1189
  • Fax: 612-545-1535
Mailing address:
  • Phone: 612-400-1189
  • Fax: 612-545-1535

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. BURHAN SHIRE
Title or Position: OWNER
Credential:
Phone: 612-400-1189