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Organization

GOLDEN FRONTIER HOMA CARE INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
FATUMA D KOTILE (OWNER/ ADMINISTER)
(651) 890-6055
Entity
Organization

Contact information

Practice address
3226 HAMLET DR, WOODBURY, MN 55125-2709
(651) 890-6055
(651) 350-1033
Mailing address
3226 HAMLET DR, WOODBURY, MN 55125-2709
(651) 890-6055
(651) 350-1033

Taxonomy

Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary

Other

Enumeration date
06/07/2023
Last updated
06/07/2023
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