MEDICARE: ALL FAMILY HOME CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1659812956
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALL FAMILY HOME CARE LLC

Provider Business Mailing Address
First Line	:	2312 7TH ST N
Second Line	:
City	:	NORTH SAINT PAUL
State	:	MN
Zip	:	55109-2845
Country	:	US
Telephone Number	:	763-634-7915
Fax Number	:	763-392-0033

Provider Business Practice Location Address
First Line	:	2312 7TH ST N
Second Line	:
City	:	NORTH SAINT PAUL
State	:	MN
Zip	:	55109-2845
Country	:	US
Telephone Number	:	763-634-7915
Fax Number	:	763-392-0033

Authorized Official
Title or Position	:	PRESIDENT
Name	:	AUGUSTINE AMBE
Credential	:
Telephone Number	:	651-332-9262

Provider Enumeration Date	:	03/20/2017
Last Update Date	:	04/01/2019

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