Organization Active NPI

Big Brothers Home Health Care, LLC

  • Home Health Agency
  • Roseville, MN
National Provider Identifier
1104125251
Registry record updated Mar 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
BIG BROTHERS HOME HEALTH CARE, LLC
Practice address
2499 Rice St
Suite 132
Roseville, MN 55113-3724
Phone
(651) 494-9058
Fax
(651) 494-6680
NPI assigned
Mar 15, 2011
Last updated
Mar 15, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Pou Ly
Title
Ceo
Phone
(651) 494-9058

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

2499 Rice St
Suite 132
Roseville, MN 55113-3724

Mailing address

2499 Rice St
Suite 132
Roseville, MN 55113-3724
Phone (651) 494-9058

Other identifiers 1

IdentifierTypeStateIssuer
A889678000MedicaidMN

National Provider Directory

National Provider Directory

Locations

2499 Rice St
Ste 132
Roseville, MN 55113
Phone (651) 494-9058

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1300147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300147200000",
    "number": "1104125251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2499 RICE ST",
            "address_2": "SUITE 132",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551133724",
            "telephone_number": "651-494-9058",
            "fax_number": "651-494-6680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2499 RICE ST",
            "address_2": "SUITE 132",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551133724",
            "telephone_number": "651-494-9058",
            "fax_number": "651-494-6680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIG BROTHERS HOME HEALTH CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-15",
        "last_updated": "2011-03-15",
        "status": "A",
        "authorized_official_last_name": "LY",
        "authorized_official_first_name": "POU",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "651-494-9058"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A889678000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.