NPIMap

Organization Active NPI

Care Source Community Services

  • In Home Supportive Care Agency
  • Minneapolis, MN
National Provider Identifier
1316609829
Registry record updated Oct 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
CARE SOURCE COMMUNITY SERVICES
Practice address
920 24TH Ave NE Unit 306
Minneapolis, MN 55418-3482
Phone
(612) 310-0448
NPI assigned
Oct 12, 2021
Last updated
Oct 12, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2021

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

Authorized official

Name
Ismahan M Qalif
Title
Owner/Manager
Phone
(612) 310-0448

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X NU Primary

Addresses

Primary practice location

920 24TH Ave NE Unit 306
Minneapolis, MN 55418-3482

Mailing address

920 24TH Ave NE Unit 306
Minneapolis, MN 55418-3482
Phone (612) 310-0448

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1633996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633996800000",
    "number": "1316609829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 24TH AVE NE UNIT 306",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554183482",
            "telephone_number": "612-310-0448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 24TH AVE NE UNIT 306",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554183482",
            "telephone_number": "612-310-0448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARE SOURCE COMMUNITY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-12",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A",
        "authorized_official_last_name": "QALIF",
        "authorized_official_first_name": "ISMAHAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "612-310-0448"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2021; 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.