Healthcare Provider Details

I. General information

NPI: 1053620401
Provider Name (Legal Business Name): QUALITY ASSURANCE HOME HEALTH OF MINNESOTA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2010
Last Update Date: 10/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5353 WAYZATA BLVD STE 204
ST LOUIS PARK MN
55416-1340
US

IV. Provider business mailing address

5353 WAYZATA BLVD STE 204
ST LOUIS PARK MN
55416-1340
US

V. Phone/Fax

Practice location:
  • Phone: 952-500-9113
  • Fax: 952-303-3361
Mailing address:
  • Phone: 952-500-9113
  • Fax: 952-303-3361

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: MR. JAMES ARYEETEY
Title or Position: PRESIDENT/CEO
Credential:
Phone: 952-500-9113