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General NPI Number Information
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NPI Number | 1336583582
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Entity Type | Organization
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Legal Business Name | ANOKA PROFESSIONAL HH INC
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Dates
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Enumeration Date | 04/18/2013
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Last Update Date | 07/09/2018
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Provider Practice Location Address
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Address Line | 4211 CENTRAL AVE NE
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City | COLUMBIA HEIGHTS
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State | MN
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Zip | 55421
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Country | US
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Telephone | 763-754-4885
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Fax | 763-754-1023
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Provider Business Mailing Address
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Address Line | 4211 CENTRAL AVE NE
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City | COLUMBIA HEIGHTS
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State | MN
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Zip | 55421-2921
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Country | US
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Telephone | 763-754-4885
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Fax | 763-754-1023
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Authorized Official
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Title or Position | CEO
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Name | JEMAL YUSUF
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Credential |
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Telephone | 763-754-4885
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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 | 835147300038
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License Number State | MN
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