Healthcare Provider Details

I. General information

NPI: 1881292944
Provider Name (Legal Business Name): RELIABLE QUALITY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2020
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6053 HUDSON RD STE 265
WOODBURY MN
55125-1000
US

IV. Provider business mailing address

6053 HUDSON RD STE 265
WOODBURY MN
55125-1000
US

V. Phone/Fax

Practice location:
  • Phone: 612-806-8755
  • Fax:
Mailing address:
  • Phone: 612-806-8755
  • Fax:

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 Code385HR2065X
TaxonomyChild Physical Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: IBRAHIM ABDI HIRSI
Title or Position: AUTHORIZED AGENT
Credential:
Phone: 612-806-8755