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General NPI Number Information
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NPI Number | 1245824408
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Entity Type | Organization
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Legal Business Name | LILT HOME CARE LLC
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Dates
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Enumeration Date | 02/26/2021
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Last Update Date | 01/26/2025
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Provider Practice Location Address
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Address Line | 2400 BLAISDELL AVE STE 100
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City | MINNEAPOLIS
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State | MN
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Zip | 55404-3394
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Country | US
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Telephone | 952-484-2752
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Fax |
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Provider Business Mailing Address
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Address Line | 8049 STRATFORD CIR S
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City | SHAKOPEE
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State | MN
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Zip | 55379-3146
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Country | US
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Telephone | 952-484-2752
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Fax | 952-556-9757
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | HAMZA MOHAMED MOHAMUD
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Credential |
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Telephone | 651-208-8925
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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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