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General NPI Number Information
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NPI Number | 1316744196
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Entity Type | Organization
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Legal Business Name | COMMUNITY-CONNECT HOME CARE LLC
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Dates
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Enumeration Date | 02/27/2025
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 3001 METRO DR STE 260
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City | BLOOMINGTON
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State | MN
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Zip | 55425-4506
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Country | US
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Telephone | 952-324-5713
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Fax | 952-378-2860
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Provider Business Mailing Address
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Address Line | 3001 METRO DR STE 260
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City | BLOOMINGTON
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State | MN
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Zip | 55425-4506
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Country | US
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Telephone | 952-324-5713
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Fax | 952-378-2860
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Authorized Official
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Title or Position | CEO
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Name | DR. NEVIL GENJANG
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Credential | PHARMD
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Telephone | 240-486-4147
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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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 | 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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