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General NPI Number Information
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NPI Number | 1508144536
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Entity Type | Organization
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Legal Business Name | NORTHEAST HOME HEALTH CARE, LLC
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Dates
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Enumeration Date | 07/25/2011
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Last Update Date | 07/25/2011
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Provider Practice Location Address
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Address Line | 1101 EUCLID AVE
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City | KANSAS CITY
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State | MO
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Zip | 64127-1152
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Country | US
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Telephone | 816-255-5041
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Fax | 816-483-0130
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Provider Business Mailing Address
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Address Line | 1101 EUCLID AVE
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City | KANSAS CITY
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State | MO
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Zip | 64127-1152
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Country | US
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Telephone | 816-255-5041
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Fax | 816-483-0130
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Authorized Official
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Title or Position | DIRECTOR/DESIGNATED MANANGER
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Name | MR. FARAH MOHAMED ABDI
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Credential |
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Telephone | 816-255-5041
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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 | LC1122887
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License Number State | MO
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