Organization
PROVIDENCE HOME CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAHIMA MOHAMED ABDI (OWNER)
(612) 978-2108
Entity
Organization
Contact information
Practice address
2805 CLIFF RD E STE 200B, BURNSVILLE, MN 55337-4095
(612) 978-2108
(612) 486-9109
Mailing address
PO BOX 22304, SAINT PAUL, MN 55122-0304
(612) 978-2108
(612) 486-9109
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
08/28/2020
Last updated
06/27/2024
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