Provider Demographics
NPI:1043106057
Name:ACTIVE HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:ACTIVE HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABDIRAHMAN
Authorized Official - Middle Name:MOHAMED
Authorized Official - Last Name:ADDOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-438-4377
Mailing Address - Street 1:1115 S 8TH ST
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-1302
Mailing Address - Country:US
Mailing Address - Phone:612-438-4377
Mailing Address - Fax:
Practice Address - Street 1:1115 S 8TH ST
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-1302
Practice Address - Country:US
Practice Address - Phone:612-438-4377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health