Provider Demographics
NPI:1447837760
Name:NORTHSTAR PROFESSIONAL HOME CARE LLC
Entity type:Organization
Organization Name:NORTHSTAR PROFESSIONAL HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:HAMZA
Authorized Official - Middle Name:I
Authorized Official - Last Name:ADEM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-600-3047
Mailing Address - Street 1:7900 EXCELSIOR BLVD STE 2001
Mailing Address - Street 2:
Mailing Address - City:HOPKINS
Mailing Address - State:MN
Mailing Address - Zip Code:55343-3445
Mailing Address - Country:US
Mailing Address - Phone:651-600-3047
Mailing Address - Fax:651-500-3027
Practice Address - Street 1:7900 EXCELSIOR BLVD STE 2001
Practice Address - Street 2:
Practice Address - City:HOPKINS
Practice Address - State:MN
Practice Address - Zip Code:55343-3445
Practice Address - Country:US
Practice Address - Phone:651-600-3047
Practice Address - Fax:651-500-3027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-24
Last Update Date:2024-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health