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General NPI Number Information
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NPI Number | 1801354980
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Entity Type | Organization
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Legal Business Name | ABIB HOME CARE, LLC
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Dates
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Enumeration Date | 03/07/2019
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Last Update Date | 11/11/2019
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Provider Practice Location Address
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Address Line | 970 E HENNEPIN AVE
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City | MINNEAPOLIS
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State | MN
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Zip | 55414-1314
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Country | US
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Telephone | 612-800-3159
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7186
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City | SAINT CLOUD
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State | MN
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Zip | 56302-7186
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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 | MANAGING MEMBER
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Name | EDRIS ALI
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Credential |
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Telephone | 612-800-3159
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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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