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General NPI Number Information
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NPI Number | 1699384131
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Entity Type | Organization
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Legal Business Name | AMAZING HOME LLC
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Dates
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Enumeration Date | 07/30/2020
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Last Update Date | 07/30/2020
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Provider Practice Location Address
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Address Line | 3220 COUNTY ROAD 10 STE 117
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City | BROOKLYN CTR
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State | MN
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Zip | 55429-3073
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Country | US
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Telephone | 763-432-6557
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Fax | 833-962-6144
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Provider Business Mailing Address
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Address Line | 3220 COUNTY ROAD 10 STE 117
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City | BROOKLYN CTR
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State | MN
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Zip | 55429-3073
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Country | US
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Telephone | 763-432-6557
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Fax | 833-962-6144
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Authorized Official
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Title or Position | OWNER
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Name | RHODA PAPPOE
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Credential |
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Telephone | 763-432-6557
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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 |
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License Number State | NULL
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Taxonomy #2
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number |
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License Number State | NULL
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Taxonomy #3
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State | NULL
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Taxonomy #4
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number |
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License Number State | NULL
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Taxonomy #5
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Taxonomy Code | 3104A0630X
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Taxonomy Name | Assisted Living Facility (Behavioral Disturbances)
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License Number |
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License Number State | NULL
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Taxonomy #6
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Taxonomy Code | 311500000X
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Taxonomy Name | Alzheimer Center (Dementia Center)
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License Number |
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License Number State | NULL
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Taxonomy #7
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State | NULL
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Taxonomy #8
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State | NULL
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Taxonomy #9
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number |
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License Number State | NULL
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Taxonomy #10
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number |
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License Number State | NULL
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Taxonomy #11
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | NULL
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