Organization
WISE HOME HEALTH CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABDIKAFAR MOHAMED ADEN (PROGRAM PRESIDENT)
(612) 721-4003
Entity
Organization
Contact information
Practice address
1305 E 24TH ST, SUIT #2, MINNEAPOLIS, MN 55404-3927
(612) 721-4003
(612) 721-4015
Mailing address
1305 E 24TH ST, SUIT #2, MINNEAPOLIS, MN 55404-3927
(612) 721-4003
(612) 721-4015
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
1073655-1-HCBS
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A111432000
UMPI
MN
01
—
A293665300
UMPI
MN
Enumeration date
07/06/2016
Last updated
07/06/2016
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