MEDICARE: AMERICAN FAMILY HEALTHCARE,INC

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	253Z00000X	In Home Supportive Care Agency
2	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1790449452
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN FAMILY HEALTHCARE,INC

Provider Business Mailing Address
First Line	:	3620 CENTRAL AVE NE STE 16
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55418-4844
Country	:	US
Telephone Number	:	763-744-7960
Fax Number	:

Provider Business Practice Location Address
First Line	:	3620 CENTRAL AVE NE STE 16
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55418-4844
Country	:	US
Telephone Number	:	763-744-7960
Fax Number	:

Authorized Official
Title or Position	:	CEO/OWNER
Name	:	AMIN M YOUSUF
Credential	:
Telephone Number	:	763-744-7960

Provider Enumeration Date	:	10/28/2021
Last Update Date	:	12/28/2022

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