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General NPI Number Information
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NPI Number | 1720803182
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Entity Type | Organization
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Legal Business Name | PROCARE HOME ASSISTANCE
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Dates
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Enumeration Date | 11/20/2024
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Last Update Date | 02/11/2025
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Provider Practice Location Address
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Address Line | 1915 MN-36 ROSEVILLE
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City | ROSEVILLE
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State | MN
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Zip | 55113
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Country | US
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Telephone | 763-306-3435
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Fax |
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Provider Business Mailing Address
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Address Line | 1915 MN-36 ROSEVILLE
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City | ROSEVILLE
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State | MN
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Zip | 55113
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ABDILLAHI AHMED
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Credential |
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Telephone | 763-286-3207
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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 |
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