Healthcare Provider Details

I. General information

NPI: 1790449452
Provider Name (Legal Business Name): AMERICAN FAMILY HEALTHCARE,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2021
Last Update Date: 12/28/2022
Certification Date: 11/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3620 CENTRAL AVE NE STE 16
MINNEAPOLIS MN
55418-4844
US

IV. Provider business mailing address

3620 CENTRAL AVE NE STE 16
MINNEAPOLIS MN
55418-4844
US

V. Phone/Fax

Practice location:
  • Phone: 763-744-7960
  • Fax:
Mailing address:
  • Phone: 763-744-7960
  • 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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: AMIN M YOUSUF
Title or Position: CEO/OWNER
Credential:
Phone: 763-744-7960