Provider Demographics
NPI:1972800498
Name:UNIVERSITY HOME HEALTH CARE, LLC
Entity type:Organization
Organization Name:UNIVERSITY HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PCA
Authorized Official - Prefix:
Authorized Official - First Name:NOU
Authorized Official - Middle Name:
Authorized Official - Last Name:MOUA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-665-0226
Mailing Address - Street 1:379 UNIVERSITY AVE W STE 214
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55103-2060
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:379 UNIVERSITY AVE W STE 214
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55103-2060
Practice Address - Country:US
Practice Address - Phone:651-665-0226
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-18
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service