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General NPI Number Information
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NPI Number | 1083297899
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Entity Type | Organization
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Legal Business Name | SINA HOME CARE, LLC
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Dates
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Enumeration Date | 04/29/2021
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Last Update Date | 04/29/2021
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Provider Practice Location Address
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Address Line | 8145 STEVENS AVE S
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City | BLOOMINGTON
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State | MN
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Zip | 55420-1237
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Country | US
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Telephone | 612-965-4843
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Fax |
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Provider Business Mailing Address
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Address Line | 9641 GARFIELD AVE S UNIT 20753
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City | BLOOMINGTON
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State | MN
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Zip | 55420-4141
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Country | US
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Telephone | 612-965-4843
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Fax |
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Authorized Official
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Title or Position | OWNER/FOUNDER
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Name | MOLLY MOREAU MONTANA
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Credential |
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Telephone | 612-965-4843
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State |
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