Miriam Home Health Corporation

Primary specialty

Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X

Legal business name

MIRIAM HOME HEALTH CORPORATION

Practice address

7030 Humboldt Avenue North
Brooklyn Center, MN 55430

Phone

(763) 458-4750

Fax

(763) 561-0738

NPI assigned

Jun 27, 2016

Organization subpart

No

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

Authorized official

Name

Mrs. Alice Isatu Mansaray, REGISTERED NURSE

Title

President

Phone

(763) 458-4750

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1466985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466985600000",
    "number": "1750732202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7030 HUMBOLDT AVE N",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554301153",
            "telephone_number": "763-458-4750",
            "fax_number": "763-561-0738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7030 HUMBOLDT AVENUE NORTH",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "55430",
            "telephone_number": "763-458-4750",
            "fax_number": "763-561-0738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRIAM HOME HEALTH CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-27",
        "last_updated": "2016-06-27",
        "status": "A",
        "authorized_official_last_name": "MANSARAY",
        "authorized_official_first_name": "ALICE",
        "authorized_official_middle_name": "ISATU",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "763-458-4750",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "REGISTERED NURSE"
    },
    "taxonomies": [
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ann Elizabeth Joan Miskovich, MA, LPCC
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• Elizabeth A Moen, LPCC
• Alice Mogeni, RN

• Physical Disabilities Residential Treatment Facility in Brooklyn Center, MN
• Providers in Brooklyn Center, MN by specialty
• Physical Disabilities Residential Treatment Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2016; 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.