Organization
SHOLOM COMMUNITY ALLIANCE HOME HEALTH CARE
Active
Parent organization
SHOLOM COMMUNITY ALLIANCE HOME HEALTH CARE
Other names
Sholom Home Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
SHOLOM COMMUNITY ALLIANCE HOME HEALTH CARE
Authorized official
DOUGLAS WYCKOFF (CONTROLLER)
(952) 939-1637
Entity
Organization
Contact information
Practice address
3620 PHILLIPS PKWY, ST LOUIS PARK, MN 55426-3700
(952) 939-1515
(952) 933-1485
Mailing address
3620 PHILLIPS PKWY, ST LOUIS PARK, MN 55426-3700
(952) 939-1515
(952) 933-1485
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
355707
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
271243100
—
MN
Enumeration date
01/04/2012
Last updated
04/22/2024
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