MEDICARE: ELATED CARE L.L.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1437663507
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELATED CARE L.L.C.

Provider Business Mailing Address
First Line	:	9997 107TH AVE N
Second Line	:
City	:	MAPLE GROVE
State	:	MN
Zip	:	55369-2734
Country	:	US
Telephone Number	:	612-930-1655
Fax Number	:	612-486-9455

Provider Business Practice Location Address
First Line	:	9997 107TH AVE N
Second Line	:
City	:	MAPLE GROVE
State	:	MN
Zip	:	55369-2734
Country	:	US
Telephone Number	:	612-930-1655
Fax Number	:	612-486-9455

Authorized Official
Title or Position	:	CEO
Name	:	MR. BRANDON CARTER
Credential	:
Telephone Number	:	612-930-1655

Provider Enumeration Date	:	11/27/2017
Last Update Date	:	12/02/2020

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