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General NPI Number Information
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NPI Number | 1831596345
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Entity Type | Organization
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Legal Business Name | PRIORITY HOMES LLC
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Dates
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Enumeration Date | 11/26/2014
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Last Update Date | 11/26/2014
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Provider Practice Location Address
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Address Line | 1713 W 85TH ST
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City | BLOOMINGTON
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State | MN
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Zip | 55431-1751
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Country | US
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Telephone | 612-501-6680
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Fax |
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Provider Business Mailing Address
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Address Line | 1713 W 85TH ST
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City | BLOOMINGTON
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State | MN
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Zip | 55431-1751
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Country | US
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Telephone | 612-501-6680
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AMAL ABDI HASSAN
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Credential |
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Telephone | 612-501-6680
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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 | 370677
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License Number State | MN
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