Organization
COON RAPIDS HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IVAN MUHIDINE (VP)
(612) 770-8226
Entity
Organization
Contact information
Practice address
199 COON RAPIDS BLVD NW, COON RAPIDS, MN 55433-5831
(612) 770-8226
Mailing address
PO BOX 490246, BLAINE, MN 55449-0246
(612) 770-8226
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
01/18/2022
Last updated
01/18/2022
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