Organization Active NPI

Holistic Home LLC

  • Home Health Agency
  • Minneapolis, MN
National Provider Identifier
1720613797
Registry record updated Mar 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
HOLISTIC HOME LLC
Practice address
4659 Bryant Ave N
Minneapolis, MN 55412-1428
Phone
(612) 636-8709
NPI assigned
Mar 10, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2020

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

Authorized official

Name
Ubah Abukar Mohamed
Title
Manager
Phone
(952) 688-1800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

4659 Bryant Ave N
Minneapolis, MN 55412-1428

Mailing address

4659 Bryant Ave N
Minneapolis, MN 55412-1428
Phone (612) 636-8709

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1583798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583798400000",
    "number": "1720613797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4659 BRYANT AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554121428",
            "telephone_number": "612-636-8709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4659 BRYANT AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554121428",
            "telephone_number": "612-636-8709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLISTIC HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-10",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A",
        "authorized_official_last_name": "MOHAMED",
        "authorized_official_first_name": "UBAH",
        "authorized_official_middle_name": "ABUKAR",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "952-688-1800"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "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 Mar 10, 2020; 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.