MEDICARE: IN-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	:	1881221356
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IN-HOME CARE LLC

Provider Business Mailing Address
First Line	:	2121 NICOLLET AVE STE 202
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55404-2575
Country	:	US
Telephone Number	:	612-242-1076
Fax Number	:

Provider Business Practice Location Address
First Line	:	2121 NICOLLET AVE STE 202
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55404-2575
Country	:	US
Telephone Number	:	612-242-1076
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	JAMAL ALI GELLE
Credential	:
Telephone Number	:	612-242-1076

Provider Enumeration Date	:	03/25/2020
Last Update Date	:	09/06/2023

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