Organization
WALLINGBURG HOME CARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABDUL ABDISHAKUR (CEO)
(612) 978-1821
Entity
Organization
Contact information
Practice address
2630 UNIVERSITY AVE SE STE A158, MINNEAPOLIS, MN 55414-3264
(612) 978-1821
(612) 354-2310
Mailing address
2630 UNIVERSITY AVE SE STE A158, MINNEAPOLIS, MN 55414-3264
(612) 978-1821
(612) 354-2310
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
26340582
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A504140000
—
MN
Enumeration date
01/08/2015
Last updated
01/08/2015
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