OrganizationDiverse Home Health CareHome HealthAgenciesPractice Address3019 Minnehaha Ave Ste 10, Minneapolis, MN 55406-3099(612) 724-3194PECOS EnrollmentBased on the most recent information from CMS, provider Diverse Home Health Care does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1508002601Provider TypeOrganizationFull NameDiverse Home Health CareSubpartNoEnumeration Date12/20/2008Last Updated12/20/2008Contact InformationPractice LocationPractice Address3019 Minnehaha Ave Ste 10, Minneapolis, MN 55406-3099Phone(612) 724-3194Fax(612) 729-5224Mailing LocationMailing Address3019 Minnehaha Ave Ste 10, Minneapolis, MN 55406-3099Phone(612) 724-3194Fax(612) 729-5224Authorized OfficialNameMohamed, Adan Issa (Operation Supervisor)Phone(612) 724-3194Provider TaxonomiesCodeDescriptionLicenseCode251E00000XPrimaryDescriptionHome HealthAgenciesLicense2494835-2MinnesotaCode251E00000XDescriptionHome HealthAgenciesLicenseUnlisted IssuerMinnesota