Provider Demographics
NPI:1407507619
Name:COURAGE HOME CARE INC
Entity type:Organization
Organization Name:COURAGE HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ABDULLAHI
Authorized Official - Middle Name:MUSE
Authorized Official - Last Name:HERSI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-300-1220
Mailing Address - Street 1:1309 UNIVERSITY AVE W APT 220
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-4243
Mailing Address - Country:US
Mailing Address - Phone:651-300-1220
Mailing Address - Fax:651-389-9339
Practice Address - Street 1:1910 UNIVERSITY AVE W
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-3426
Practice Address - Country:US
Practice Address - Phone:651-300-1220
Practice Address - Fax:651-389-9889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty