Healthcare Provider Details

I. General information

NPI: 1487079265
Provider Name (Legal Business Name): CLIENT-CENTERED HOME CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2014
Last Update Date: 02/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

393 DUNLAP ST N SUITE #105
SAINT PAUL MN
55104-4200
US

IV. Provider business mailing address

393 DUNLAP STREET N, SUITE 105
SAINT PAUL MN
55104-4201
US

V. Phone/Fax

Practice location:
  • Phone: 612-245-0037
  • Fax:
Mailing address:
  • Phone: 651-600-3869
  • Fax: 651-797-4308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number366231
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number375684
License Number StateMN

VIII. Authorized Official

Name: ABDI S. WARSAME
Title or Position: DIRECTOR
Credential:
Phone: 651-600-3869