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		MN

General Provider Information

NPI Number	:	1750603643
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	:	612-840-5448
Fax Number	:	651-846-4685

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	:	612-840-5448
Fax Number	:	651-846-4685

Authorized Official
Title or Position	:	PRESIDENT
Name	:	PETER AKWICHEK
Credential	:
Telephone Number	:	612-840-5448

Provider Enumeration Date	:	02/19/2010
Last Update Date	:	02/19/2010

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