Organization
SUPREME HOME CARE PROVIDER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HASSAN OSMAN YUSUF (OWNER/MANAGER)
(763) 710-9907
Entity
Organization
Contact information
Practice address
1710 DOUGLAS DR N STE 277, GOLDEN VALLEY, MN 55422-4344
(763) 710-9907
(763) 710-9976
Mailing address
1710 DOUGLAS DR N STE 277, GOLDEN VALLEY, MN 55422-4344
(763) 710-9907
(763) 710-9976
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
MN
Other
Enumeration date
01/04/2012
Last updated
05/22/2015
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