Coon Rapids Home Care LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

COON RAPIDS HOME CARE LLC

Practice address

199 Coon Rapids Blvd NW
Coon Rapids, MN 55433-5831

Phone

(612) 770-8226

NPI assigned

Jan 18, 2022

Last updated

Jan 18, 2022By 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

Ivan Muhidine

Title

VP

Phone

(612) 770-8226

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1642464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642464000000",
    "number": "1912658246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 490246",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554490246",
            "telephone_number": "612-770-8226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 COON RAPIDS BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554335831",
            "telephone_number": "612-770-8226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COON RAPIDS HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-18",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A",
        "authorized_official_last_name": "MUHIDINE",
        "authorized_official_first_name": "IVAN",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "612-770-8226"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Elizabeth Conner, MA LP
• Jennifer Connolly, LADC
• Kelly Connolly, LICSW
• Kelsey Cooke
• Jodie Coombs, M.D.
• Coon Rapids Modern Dentistry, PC (Coon Rapids Modern Dentistry)
• Alexis Jo Cooper
• Erikah Cooper
• Sylvia Copeland
• Cassandra Susan Cordova, LSW

• In Home Supportive Care Agency in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• In Home Supportive Care Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2022; 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.