Provider Demographics
NPI:1124469465
Name:GENTLE HANDS HOME CARE LLC
Entity type:Organization
Organization Name:GENTLE HANDS HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:ABDIRIZAK
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-594-5389
Mailing Address - Street 1:2128 E 117TH ST
Mailing Address - Street 2:UNIT E
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-7227
Mailing Address - Country:US
Mailing Address - Phone:952-594-5389
Mailing Address - Fax:
Practice Address - Street 1:1519 E FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-2137
Practice Address - Country:US
Practice Address - Phone:952-594-5389
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-16
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNK431139163408251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health