# MIRIAM HOME HEALTH CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750732202
- **Authorized official:** MRS. ALICE ISATU MANSARAY REGISTERED NURSE (PRESIDENT)
- **Authorized official phone:** (763) 458-4750

## Contact information

- **Practice address:** 7030 HUMBOLDT AVENUE NORTH, BROOKLYN CENTER, MN 55430
- **Practice address phone:** (763) 458-4750
- **Practice address fax:** (763) 561-0738
- **Mailing address:** 7030 HUMBOLDT AVE N, BROOKLYN CENTER, MN 55430-1153
- **Mailing address phone:** (763) 458-4750
- **Mailing address fax:** (763) 561-0738

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320700000X | Physical Disabilities Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 06/27/2016
- **Last updated:** 06/27/2016