Provider Demographics
NPI:1386101129
Name:ASPEN HOME HEALTH CARE
Entity type:Organization
Organization Name:ASPEN HOME HEALTH CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FATHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOUSSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-876-1913
Mailing Address - Street 1:8525 EDITHBROOK CROSSING
Mailing Address - Street 2:SUITE 104A
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55443-1900
Mailing Address - Country:US
Mailing Address - Phone:612-876-1913
Mailing Address - Fax:763-205-1584
Practice Address - Street 1:8525 EDITHBROOK CROSSING
Practice Address - Street 2:SUITE 104A
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55443-1900
Practice Address - Country:US
Practice Address - Phone:612-876-1913
Practice Address - Fax:763-205-1584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-28
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness