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General NPI Number Information
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NPI Number | 1407507619
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Entity Type | Organization
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Legal Business Name | COURAGE HOME CARE INC
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Dates
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Enumeration Date | 01/10/2022
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Last Update Date | 01/10/2022
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Provider Practice Location Address
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Address Line | 1910 UNIVERSITY AVE W
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City | SAINT PAUL
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State | MN
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Zip | 55104-3426
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Country | US
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Telephone | 651-300-1220
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Fax | 651-389-9889
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Provider Business Mailing Address
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Address Line | 1309 UNIVERSITY AVE W APT 220
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City | SAINT PAUL
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State | MN
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Zip | 55104-4243
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Country | US
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Telephone | 651-300-1220
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Fax | 651-389-9339
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Authorized Official
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Title or Position | MANAGER
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Name | ABDULLAHI MUSE HERSI
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Credential |
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Telephone | 651-300-1220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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