Organization
IMMACULATE HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KAYODE TAIWO (OWNER/MANAGER)
(763) 670-5597
Entity
Organization
Contact information
Practice address
3731 IDAHO AVENUE EAST, ST. PAUL, MN 55106
(651) 666-2135
(651) 666-2137
Mailing address
3731 IDAHO AVENUE EAST, ST. PAUL, MN 55106
(651) 666-2135
(651) 666-2137
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
MN
Other
Enumeration date
01/19/2018
Last updated
06/13/2019
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