Pilgrim Home Care, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

32048 Issued in MN

Legal business name

PILGRIM HOME CARE, LLC

Practice address

3300 County Road 10
Suite 320M
Brooklyn Center, MN 55429-3072

Phone

(763) 400-1326

Fax

(763) 307-5942

NPI assigned

Nov 7, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Mark Y Nyemah III, RN

Title

Administrator/Owner

Phone

(763) 400-1326

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1446854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446854400000",
    "number": "1336512797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 COUNTY ROAD 10",
            "address_2": "SUITE 320M",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554293072",
            "telephone_number": "763-400-1326",
            "fax_number": "763-307-5942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 COUNTY ROAD 10",
            "address_2": "SUITE 320M",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554293072",
            "telephone_number": "763-400-1326",
            "fax_number": "763-307-5942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PILGRIM HOME CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-07",
        "last_updated": "2015-11-07",
        "status": "A",
        "authorized_official_last_name": "NYEMAH",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "ADMINISTRATOR/OWNER",
        "authorized_official_telephone_number": "763-400-1326",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MN",
            "license": "32048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Brooklyn Center, MN
• Providers in Brooklyn Center, MN by specialty
• Home Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2015; 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.