Provider Demographics
NPI:1992343925
Name:CAREXTRA HOME HEALTH, LLC
Entity type:Organization
Organization Name:CAREXTRA HOME HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IDIL
Authorized Official - Middle Name:ABDIRAHMAN
Authorized Official - Last Name:MOHAMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-987-3927
Mailing Address - Street 1:544 ARTHUR ST
Mailing Address - Street 2:
Mailing Address - City:HOPKINS
Mailing Address - State:MN
Mailing Address - Zip Code:55343-8414
Mailing Address - Country:US
Mailing Address - Phone:952-681-7196
Mailing Address - Fax:
Practice Address - Street 1:544 ARTHUR ST
Practice Address - Street 2:
Practice Address - City:HOPKINS
Practice Address - State:MN
Practice Address - Zip Code:55343-8414
Practice Address - Country:US
Practice Address - Phone:612-987-3927
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-20
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health