Alpha Group Home LLC
Home Health in Minneapolis, MN. Organization (NPI-2).
NPI number1477230647
StatusActive
Last updated in NPPESMar 16, 2025
Details
- NPI
- 1477230647
- Entity type
- Organization (NPI-2)
- Legal business name
- Alpha Group Home LLC
- Organization subpart
- No
- Enumeration date
- Jun 29, 2023
- Certification date
- Mar 16, 2025
- Last updated
- Mar 16, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251E00000X | Home Health | – | – | Yes |
| 253Z00000X | In Home Supportive Care | – | – |
Practice location
2915 S Wayzata BlvdMinneapolis, MN 55405-2145
Phone 612-558-4384 · Fax 612-486-7304
Mailing address
2915 Wayzata Blvd Ste 103Minneapolis, MN 55405-2145
Phone 612-558-4384 · Fax 612-486-7304
Authorized official
Abdulkadir Ismail Jama
Owner
6125584384
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