Organization Active NPI

Sheba

  • In Home Supportive Care Agency
  • Maplewood, MN
National Provider Identifier
1124838123
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
SHEBA
Practice address
2303 Dahl Ave E
Maplewood, MN 55119-5831
Phone
(651) 354-8821
NPI assigned
Jan 10, 2025
Organization subpart
Yes
Parent organization
SHEBAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

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

Authorized official

Name
Simele Adimasu
Title
Manager
Phone
(651) 354-8821

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary
Home Health AideGroup: 193400000X SINGLE SPECIALTY GROUP 374U00000X

Addresses

Primary practice location

2303 Dahl Ave E
Maplewood, MN 55119-5831

Mailing address

2303 Dahl Ave E
Maplewood, MN 55119-5831
Phone (651) 354-8821

Other names 1

  • Amen Home Care Service Doing business as

National Provider Directory

National Provider Directory
Part of
Sheba

NPI Registry JSON

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

{
    "created_epoch": "1736467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736467200000",
    "number": "1124838123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2303 DAHL AVE E",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551195831",
            "telephone_number": "651-354-8821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2303 DAHL AVE E",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551195831",
            "telephone_number": "651-354-8821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHEBA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SHEBA",
        "enumeration_date": "2025-01-10",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A",
        "authorized_official_last_name": "ADIMASU",
        "authorized_official_first_name": "SIMELE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "651-354-8821"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Amen Home Care Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Maplewood, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2025; 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.