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General NPI Number Information
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NPI Number | 1902198070
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Entity Type | Organization
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Legal Business Name | AGABI HEALTH CARE SERVICES
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Dates
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Enumeration Date | 05/09/2011
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Last Update Date | 05/09/2011
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Provider Practice Location Address
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Address Line | 7259 SAVANNA CT
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City | LINO LAKES
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State | MN
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Zip | 55014-1198
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Country | US
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Telephone | 763-458-5601
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Fax |
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Provider Business Mailing Address
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Address Line | 7259 SAVANNA CT
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City | LINO LAKES
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State | MN
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Zip | 55014-1198
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Country | US
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Telephone | 763-458-5601
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. VICTORINE AMBE
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Credential |
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Telephone | 952-381-7697
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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 | 27854
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License Number State | MN
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