Healthcare Provider Details

I. General information

NPI: 1184335903
Provider Name (Legal Business Name): TRIPLE A NURSING CARE GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2022
Last Update Date: 05/09/2025
Certification Date: 05/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2230 26TH AVE NW
ROCHESTER MN
55901-8057
US

IV. Provider business mailing address

2230 26TH AVE NW
ROCHESTER MN
55901-8057
US

V. Phone/Fax

Practice location:
  • Phone: 507-990-2474
  • Fax: 507-540-8175
Mailing address:
  • Phone: 507-990-2474
  • Fax: 507-540-8175

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: WUDNEH O GAGA
Title or Position: MANAGER
Credential: RN
Phone: 507-990-2474