Provider Demographics
NPI:1063944940
Name:RAJO HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:RAJO HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:HASSAN
Authorized Official - Last Name:JAMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-644-8089
Mailing Address - Street 1:1813 S 6TH ST STE 204
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55454-1208
Mailing Address - Country:US
Mailing Address - Phone:612-200-9297
Mailing Address - Fax:612-259-7446
Practice Address - Street 1:1813 S 6TH ST # 204
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55454-1208
Practice Address - Country:US
Practice Address - Phone:612-200-9297
Practice Address - Fax:612-259-7446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-30
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN251E00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN=========OtherHOME HEALTH CARE