Provider Demographics
NPI:1366084089
Name:HONESTY CARE HOME LLC
Entity type:Organization
Organization Name:HONESTY CARE HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHUKRI
Authorized Official - Middle Name:
Authorized Official - Last Name:WARSAME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-388-7025
Mailing Address - Street 1:12708 WAYZATA BLVD APT 101
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55305-1924
Mailing Address - Country:US
Mailing Address - Phone:952-388-7025
Mailing Address - Fax:
Practice Address - Street 1:12708 WAYZATA BLVD APT 101
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-1924
Practice Address - Country:US
Practice Address - Phone:952-388-7025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-15
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty