Organization
FAYYAA HOME HEALTH CARE SERVICES, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TADESSE GELETA NEGASA RN (OWNER/MANAGER)
(612) 707-4741
Entity
Organization
Contact information
Practice address
7108 CHICAGO AVE #1, RICHFIELD, MN 55423-3478
(612) 707-4741
Mailing address
7108 CHICAGO AVE #1, RICHFIELD, MN 55423-3478
(612) 707-4741
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A565413200
MINNESOTA DEPARTMENT OF HUMAN SERVICES
MN
Enumeration date
04/16/2019
Last updated
07/09/2019
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