Provider Demographics
NPI:1275779522
Name:SAMAD HOME HEALTH CARE, LLC
Entity type:Organization
Organization Name:SAMAD HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASH
Authorized Official - Middle Name:
Authorized Official - Last Name:FARAH
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:651-552-7764
Mailing Address - Street 1:149 THOMPSON AVE E
Mailing Address - Street 2:SUITE # 207
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55118-3238
Mailing Address - Country:US
Mailing Address - Phone:651-552-7764
Mailing Address - Fax:651-552-9051
Practice Address - Street 1:149 THOMPSON AVE E
Practice Address - Street 2:SUITE # 207
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55118-3238
Practice Address - Country:US
Practice Address - Phone:651-552-7764
Practice Address - Fax:651-552-9051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-16
Last Update Date:2008-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNHE-01084-04251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health