Organization
AMANI HEALTH CARE SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SIMON MOMANYI NYAMARI RN (MANAGING COORDINATING OFFICER)
(952) 564-9086
Entity
Organization
Contact information
Practice address
1705 SOUTHCROSS DR W STE 105, BURNSVILLE, MN 55306-7012
(952) 683-1628
(952) 683-1629
Mailing address
1705 SOUTHCROSS DR W STE 105, BURNSVILLE, MN 55306-7012
(952) 683-1628
(952) 683-1629
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A116450100
MA, CADI WAIVER
MN
01
—
A836410600
MA, CADI WAIVER
MN
Enumeration date
03/06/2020
Last updated
03/06/2020
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