Healthcare Provider Details

I. General information

NPI: 1396313326
Provider Name (Legal Business Name): HOBBS HOME HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2021
Last Update Date: 03/02/2022
Certification Date: 03/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1821 UNIVERSITY AVE W STE 225
SAINT PAUL MN
55104-2895
US

IV. Provider business mailing address

1821 UNIVERSITY AVE W STE 225
SAINT PAUL MN
55104-2895
US

V. Phone/Fax

Practice location:
  • Phone: 612-300-4685
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MOHAMED MOHAMOUD ISSE
Title or Position: OWNER/MANAGER
Credential:
Phone: 612-300-4685