Provider Demographics
NPI:1902070584
Name:KAAL HOME HEALTHCARE, INC
Entity Type:Organization
Organization Name:KAAL HOME HEALTHCARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SABAH
Authorized Official - Middle Name:A
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-872-1950
Mailing Address - Street 1:2700 E. 28TH STREET
Mailing Address - Street 2:SUITE 170
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55406
Mailing Address - Country:US
Mailing Address - Phone:612-872-1950
Mailing Address - Fax:612-872-1788
Practice Address - Street 1:2700 E. 28TH STREET
Practice Address - Street 2:SUITE 170
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55406
Practice Address - Country:US
Practice Address - Phone:612-872-1950
Practice Address - Fax:612-872-1788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-15
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN126952000251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN126952000Medicaid