Provider Demographics
NPI:1871143958
Name:HOME TO HOME HEALTHCARE SERVICE
Entity type:Organization
Organization Name:HOME TO HOME HEALTHCARE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BEZA
Authorized Official - Middle Name:F
Authorized Official - Last Name:MEKONNEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:651-428-1831
Mailing Address - Street 1:13413 PARKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-8513
Mailing Address - Country:US
Mailing Address - Phone:651-428-1831
Mailing Address - Fax:
Practice Address - Street 1:13413 PARKWOOD DR
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-8513
Practice Address - Country:US
Practice Address - Phone:651-428-1831
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-19
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health