Provider Demographics
NPI:1124819685
Name:ASSISTED HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:ASSISTED HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KHADRA
Authorized Official - Middle Name:
Authorized Official - Last Name:KHADRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-601-7833
Mailing Address - Street 1:2626 E 82ND ST STE 305
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-1683
Mailing Address - Country:US
Mailing Address - Phone:612-601-7833
Mailing Address - Fax:
Practice Address - Street 1:2626 E 82ND ST STE 305
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55425-1683
Practice Address - Country:US
Practice Address - Phone:612-601-7833
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health