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General NPI Number Information
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NPI Number | 1114821733
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Entity Type | Organization
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Legal Business Name | SUPPORT CARE LLC
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Dates
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Enumeration Date | 10/06/2026
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Last Update Date | 10/06/2026
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Provider Practice Location Address
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Address Line | 3450 LEXINGTON AVE N STE 124
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City | SHOREVIEW
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State | MN
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Zip | 55126-8071
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Country | US
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Telephone | 651-207-7701
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Fax |
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Provider Business Mailing Address
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Address Line | 3450 LEXINGTON AVE N STE 124
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City | SHOREVIEW
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State | MN
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Zip | 55126-8071
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Country | US
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Telephone | 651-207-7701
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SAMIRA ABDIRAHMAN IBRAHIM
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Credential |
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Telephone | 651-207-7701
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number |
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License Number State | NULL
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