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General NPI Number Information
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NPI Number | 1144370610
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Entity Type | Organization
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Legal Business Name | PRIDE N LIVING HOME CARE INC .
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 05/22/2025
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Provider Practice Location Address
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Address Line | 7691 CENTRAL AVE NE SUITE 102
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City | FRIDLEY
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State | MN
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Zip | 55432-3560
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Country | US
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Telephone | 763-572-2390
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Fax | 763-574-2459
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Provider Business Mailing Address
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Address Line | 7691 CENTRAL AVE NE SUITE 102
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City | FRIDLEY
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State | MN
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Zip | 55432-3560
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Country | US
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Telephone | 763-572-2390
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Fax | 763-574-2459
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Authorized Official
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Title or Position | CEO
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Name | KAREN NABUIN WAINDIM
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Credential |
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Telephone | 651-271-2291
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | R 138395-9
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License Number State | MN
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