Provider Demographics
NPI:1952599193
Name:CBD HOMECARE, INC.
Entity type:Organization
Organization Name:CBD HOMECARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EMEKA LINUS
Authorized Official - Middle Name:CHIKWELU
Authorized Official - Last Name:OKAFOR
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:763-493-5067
Mailing Address - Street 1:10650 COUNTY ROAD 81
Mailing Address - Street 2:SUITE 207
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55369-4075
Mailing Address - Country:US
Mailing Address - Phone:763-493-5067
Mailing Address - Fax:763-493-5138
Practice Address - Street 1:10650 COUNTY ROAD 81
Practice Address - Street 2:SUITE 207
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-4075
Practice Address - Country:US
Practice Address - Phone:763-493-5067
Practice Address - Fax:763-493-5138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-12
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN337936251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health