Organization · NPI-2
Agility Advantage Home Healthcare LLC
Assisted Living Facility · Brooklyn Park, MN
NPI number1083172985
StatusActive
Last updated in NPPESMar 10, 2019
Details
- NPI
- 1083172985
- Entity type
- Organization (NPI-2)
- Legal business name
- Agility Advantage Home Healthcare LLC
- Organization subpart
- No
- Enumeration date
- Mar 10, 2019
- Last updated
- Mar 10, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 310400000X | Assisted Living Facility | – | – | Yes |
| 251E00000X | Home Health | – | – | |
| 251J00000X | Nursing Care | – | – | |
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – | |
| 332U00000X | Home Delivered Meals | – | – |
Practice location
10339 Quail Cir NBrooklyn Park, MN 55443-5418
Phone 612-212-9212
Mailing address
10339 Quail Cir NBrooklyn Park, MN 55443-5418
Phone 612-212-9212
Authorized official
Dimitra Tumba Kaulu
Owner/Manager
6122129212
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