Provider Demographics
NPI:1487250809
Name:F AND K HOMECARE SERVICES LLC
Entity type:Organization
Organization Name:F AND K HOMECARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:
Authorized Official - Last Name:KANNEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-318-5371
Mailing Address - Street 1:5701 SHINGLE CREEK PKWY STE 422
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55430-2467
Mailing Address - Country:US
Mailing Address - Phone:763-318-5371
Mailing Address - Fax:763-207-1764
Practice Address - Street 1:5701 SHINGLE CREEK PKWY STE 422
Practice Address - Street 2:
Practice Address - City:BROOKLYN CENTER
Practice Address - State:MN
Practice Address - Zip Code:55430-2467
Practice Address - Country:US
Practice Address - Phone:763-318-5371
Practice Address - Fax:763-207-1764
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-10
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities