Immaculate Home Care LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

IMMACULATE HOME CARE LLC

Practice address

3731 Idaho Avenue East
St. Paul, MN 55106

Phone

(651) 666-2135

Fax

(651) 666-2137

NPI assigned

Jan 19, 2018

Last updated

Jun 13, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Kayode Taiwo

Title

Owner/Manager

Phone

(763) 670-5597

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1516320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560384000000",
    "number": "1407364813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3731 IDAHO AVENUE EAST",
            "city": "ST. PAUL",
            "state": "MN",
            "postal_code": "55106",
            "telephone_number": "651-666-2135",
            "fax_number": "651-666-2137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3731 IDAHO AVENUE EAST",
            "city": "ST. PAUL",
            "state": "MN",
            "postal_code": "55106",
            "telephone_number": "651-666-2135",
            "fax_number": "651-666-2137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMMACULATE HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-19",
        "last_updated": "2019-06-13",
        "status": "A",
        "authorized_official_last_name": "TAIWO",
        "authorized_official_first_name": "KAYODE",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "763-670-5597",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2019; 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.