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General NPI Number Information
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NPI Number | 1942609425
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Entity Type | Organization
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Legal Business Name | AMERICAN HOME HEALTH AIDE LLC
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Dates
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Enumeration Date | 08/20/2014
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Last Update Date | 02/02/2016
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Provider Practice Location Address
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Address Line | 4651 NICOLS RD SUITE 205
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City | EAGAN
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State | MN
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Zip | 55122-3336
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Country | US
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Telephone | 651-452-2287
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Fax | 651-454-8328
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Provider Business Mailing Address
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Address Line | 4651 NICOLS RD SUITE 205
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City | EAGAN
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State | MN
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Zip | 55122-3336
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Country | US
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Telephone | 651-452-2287
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Fax | 651-454-8328
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Authorized Official
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Title or Position | OWNER
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Name | SHERWA NUR
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Credential |
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Telephone | 651-452-2287
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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 | 367586
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License Number State | MN
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