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General NPI Number Information
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NPI Number | 1619209962
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Entity Type | Organization
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Legal Business Name | ANIKA HOME CARE, LLC
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Dates
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Enumeration Date | 02/10/2010
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Last Update Date | 02/21/2013
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Provider Practice Location Address
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Address Line | 3144 78TH ST E
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City | INVER GROVE HEIGHTS
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State | MN
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Zip | 55076-3042
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Country | US
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Telephone | 612-850-9021
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Fax |
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Provider Business Mailing Address
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Address Line | 3144 78TH ST E
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City | INVER GROVE HEIGHTS
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State | MN
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Zip | 55076-3042
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Country | US
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Telephone | 612-850-9021
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | JUMA S. ARTEMA
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Credential |
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Telephone | 612-850-9022
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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 | 346949
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License Number State | MN
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