Provider Demographics
NPI:1730072455
Name:COMMUNITY-CONNECT HOME CARE LLC
Entity type:Organization
Organization Name:COMMUNITY-CONNECT HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:NEVIL
Authorized Official - Middle Name:NUVALA
Authorized Official - Last Name:GENJANG
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:952-324-5713
Mailing Address - Street 1:3001 METRO DR STE 260
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4506
Mailing Address - Country:US
Mailing Address - Phone:952-324-5713
Mailing Address - Fax:952-378-2860
Practice Address - Street 1:3001 METRO DR STE 260
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55425-4506
Practice Address - Country:US
Practice Address - Phone:952-324-5713
Practice Address - Fax:952-378-2860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)