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General NPI Number Information
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NPI Number | 1568293793
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Entity Type | Organization
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Legal Business Name | HEALTHGROUPHOMECARE LLC
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Dates
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Enumeration Date | 08/09/2024
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 8030 OLD CEDAR AVE S STE 227C
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City | BLOOMINGTON
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State | MN
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Zip | 55425-1203
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Country | US
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Telephone | 612-806-7460
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Fax |
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Provider Business Mailing Address
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Address Line | 8030 OLD CEDAR AVE S STE 227C
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City | BLOOMINGTON
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State | MN
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Zip | 55425-1203
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Country | US
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Telephone | 612-806-7460
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED PERSON
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Name | JAMAL MOHAMED ABDI
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Credential |
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Telephone | 612-806-7460
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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