Organization
AGILITY ADVANTAGE HOME HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIMITRA TUMBA KAULU LRT, CRT (OWNER/MANAGER)
(612) 212-9212
Entity
Organization
Contact information
Practice address
10339 QUAIL CIR N, BROOKLYN PARK, MN 55443-5418
(612) 212-9212
Mailing address
10339 QUAIL CIR N, BROOKLYN PARK, MN 55443-5418
(612) 212-9212
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
251J00000X
Nursing Care Agency
—
—
310400000X
Assisted Living Facility
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332U00000X
Home Delivered Meals
—
—
Other
Enumeration date
03/10/2019
Last updated
03/10/2019
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