Provider Demographics
NPI:1043069438
Name:ANOKA HOME CARE LLC
Entity type:Organization
Organization Name:ANOKA HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANGER
Authorized Official - Prefix:
Authorized Official - First Name:GUTA
Authorized Official - Middle Name:
Authorized Official - Last Name:NAGAYO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-481-2995
Mailing Address - Street 1:15172 WOLVERINE ST NW
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:MN
Mailing Address - Zip Code:55303-5530
Mailing Address - Country:US
Mailing Address - Phone:612-481-2995
Mailing Address - Fax:
Practice Address - Street 1:15172 WOLVERINE ST NW
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:MN
Practice Address - Zip Code:55303-5530
Practice Address - Country:US
Practice Address - Phone:612-481-2995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-16
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health