Organization
SUPREME CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMED A ISSE (ADMINISTRATOR)
(612) 388-1894
Entity
Organization
Contact information
Practice address
1433 E FRANKLIN AVE STE 7A, MINNEAPOLIS, MN 55404-2101
(612) 388-1894
Mailing address
1433 E FRANKLIN AVE STE 7A, MINNEAPOLIS, MN 55404-2101
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
334523
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
334523
MN CLASS A LICENSE
MN
Enumeration date
01/29/2007
Last updated
08/22/2020
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