Organization
BIG BROTHERS HOME HEALTH CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
POU LY (CEO)
(651) 494-9058
Entity
Organization
Contact information
Practice address
2499 RICE ST, SUITE 132, ROSEVILLE, MN 55113-3724
(651) 494-9058
(651) 494-6680
Mailing address
2499 RICE ST, SUITE 132, ROSEVILLE, MN 55113-3724
(651) 494-9058
(651) 494-6680
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A889678000
—
MN
Enumeration date
03/15/2011
Last updated
03/15/2011
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