Provider Demographics
NPI:1538810551
Name:COZY BARAKA HOME CARE INC.,
Entity type:Organization
Organization Name:COZY BARAKA HOME CARE INC.,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARDIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:JAFFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-808-8280
Mailing Address - Street 1:1545 GERMAIN LNDG
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55106-3677
Mailing Address - Country:US
Mailing Address - Phone:651-808-8280
Mailing Address - Fax:
Practice Address - Street 1:2925 REGENT AVE N
Practice Address - Street 2:
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55422-2732
Practice Address - Country:US
Practice Address - Phone:651-808-8280
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-11
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health