Organization
DIVERSIFIED HOME CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABDI ALI GURE (PRESIDENT & CEO)
(612) 721-1115
Entity
Organization
Contact information
Practice address
1304 E LAKE ST STE 204, MINNEAPOLIS, MN 55407-1777
(612) 721-1115
(612) 721-1131
Mailing address
1304 E LAKE ST STE 204, MINNEAPOLIS, MN 55407-1777
(612) 721-1115
(612) 721-1131
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
0622443000
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0622443000
MHCP PROVIDER NUMBER
MN
Enumeration date
03/18/2008
Last updated
03/18/2008
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