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General NPI Number Information
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NPI Number | 1093043804
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Entity Type | Organization
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Legal Business Name | METRO HEALTH CARE SERVICES LLC
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Dates
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Enumeration Date | 12/07/2009
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1322 BURKE CIR E
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City | MAPLEWOOD
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State | MN
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Zip | 55109-3450
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Country | US
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Telephone | 651-348-7247
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Fax | 651-756-1696
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Provider Business Mailing Address
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Address Line | 1322 BURKE CIR E
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City | MAPLEWOOD
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State | MN
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Zip | 55109-3450
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Country | US
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Telephone | 651-348-7247
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Fax | 651-756-1696
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DR. ABDI GALGALO GONJOBE
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Credential | M.D.
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Telephone | 651-348-7247
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 379351
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License Number State | MN
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