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General NPI Number Information
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NPI Number | 1407658081
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Entity Type | Organization
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Legal Business Name | ORCHARD HEALTH CARE
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Dates
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Enumeration Date | 03/25/2025
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 7709 ORCHARD AVE N
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City | BROOKLYN PARK
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State | MN
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Zip | 55443-3340
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Country | US
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Telephone | 612-807-5021
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Fax |
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Provider Business Mailing Address
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Address Line | 7709 ORCHARD AVE N
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City | BROOKLYN PARK
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State | MN
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Zip | 55443-3340
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER AND EXECUTIVE DIRECTOR
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Name | JENGEIH TAMBA
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Credential | ESQ
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Telephone | 612-807-5021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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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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