Organization
LAKESIDE HOME HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AHMED ABDULKADIR (EXECUTIVE DIRECTOR)
(651) 363-2020
Entity
Organization
Contact information
Practice address
4124 QUEBEC AVE N STE 202, NEW HOPE, MN 55427-1240
(651) 363-2020
Mailing address
4124 QUEBEC AVE N STE 202, NEW HOPE, MN 55427-1240
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
11/13/2023
Last updated
11/13/2023
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