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General NPI Number Information
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NPI Number | 1669693016
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Entity Type | Organization
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Legal Business Name | MY HOME HEALTH CARE, INC.
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 3629 WHITE BEAR AVE N
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City | WHITE BEAR LAKE
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State | MN
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Zip | 55110-4745
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Country | US
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Telephone | 651-488-3126
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Fax | 651-487-7637
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Provider Business Mailing Address
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Address Line | 3629 WHITE BEAR AVE N
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City | WHITE BEAR LAKE
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State | MN
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Zip | 55110-4745
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Country | US
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Telephone | 651-488-3126
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Fax | 651-487-7637
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Authorized Official
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Title or Position | CEO
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Name | MAI YER SOUNG
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Credential |
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Telephone | 651-274-2538
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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 | 234842000
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License Number State | MN
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