Healthcare Provider Details

I. General information

NPI: 1225118342
Provider Name (Legal Business Name): TAYO HOME HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 12/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 E FRANKLIN AVE STE 9
MINNEAPOLIS MN
55404-2558
US

IV. Provider business mailing address

2 E FRANKLIN SUITE 9
MINNEAPOLIS MN
55404-2558
US

V. Phone/Fax

Practice location:
  • Phone: 612-871-6328
  • Fax: 612-874-0454
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number329379
License Number StateMN

VIII. Authorized Official

Name: MR. ALI ABDI JAMA
Title or Position: PRESIDEN
Credential:
Phone: 612-871-6328