Provider Demographics
NPI:1194086520
Name:SENIOR HOME HEALTH CARE, LLC
Entity type:Organization
Organization Name:SENIOR HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEYLANI
Authorized Official - Middle Name:
Authorized Official - Last Name:HASHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-855-7786
Mailing Address - Street 1:7800 METRO PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-1528
Mailing Address - Country:US
Mailing Address - Phone:952-855-7786
Mailing Address - Fax:952-855-7784
Practice Address - Street 1:7800 METRO PKWY STE 100
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55425-1528
Practice Address - Country:US
Practice Address - Phone:952-855-7786
Practice Address - Fax:952-855-7784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN490865700028251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health