Organization
IMED HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVANS MORONGE MOGAKA (ADMINISTRATOR)
(612) 730-4235
Entity
Organization
Contact information
Practice address
4309 W OLD SHAKOPEE RD, BLOOMINGTON, MN 55437-2952
(612) 730-4235
Mailing address
10800 LYNDALE AVE S STE 150, BLOOMINGTON, MN 55420-5698
(612) 730-4235
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
06/15/2022
Last updated
06/15/2022
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