Provider Demographics
NPI:1306132337
Name:YMG HOME CARE
Entity type:Organization
Organization Name:YMG HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:YAKOV
Authorized Official - Middle Name:
Authorized Official - Last Name:GITERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-412-3545
Mailing Address - Street 1:5811 CEDAR LAKE RD S
Mailing Address - Street 2:UNITE G
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-1458
Mailing Address - Country:US
Mailing Address - Phone:952-412-3545
Mailing Address - Fax:
Practice Address - Street 1:5811 CEDAR LAKE RD S
Practice Address - Street 2:UNITE G
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-1458
Practice Address - Country:US
Practice Address - Phone:952-412-3545
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-28
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNA394906100Medicaid