Organization
SHINING ANGELS CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AYAN MOHYIDIN DHORE (REGISTERED NURSE)
(952) 686-8491
Entity
Organization
Contact information
Practice address
17162 NEW MARKET DR, EDEN PRAIRIE, MN 55347-5331
(952) 686-8491
Mailing address
17162 NEW MARKET DR, EDEN PRAIRIE, MN 55347-5331
(952) 686-8491
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
—
—
Other
Enumeration date
12/12/2023
Last updated
12/12/2023
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