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NPI Code Detail

MEDICARE: CARING HEART HOME HEALTHCRAE, LLC

MEDICARE: CARING HEART HOME HEALTHCRAE, LLC
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
1374U00000XHome Health Aide

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1A065413300OTHERMNHOME HEALTHCARE

General Provider Information

NPI Number : 1497371439
Entity Type Code : Organization
Provider Name (Legal Business Name) : CARING HEART HOME HEALTHCRAE, LLC
Provider Business Mailing Address
First Line : 1200 W BROADWAY AVE # 130
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55411-2572
Country : US
Telephone Number : 612-298-8037
Fax Number : 952-303-4664
Provider Business Practice Location Address
First Line : 1200 W BROADWAY AVE # 130
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55411-2572
Country : US
Telephone Number : 612-298-8037
Fax Number : 952-303-4664
Authorized Official
Title or Position : OWNER OF OPERATIONS
Name : MS. DARSHAE DECOLE UNDERWOOD
Credential :
Telephone Number : 612-298-8037
Provider Enumeration Date : 06/24/2020
Last Update Date : 06/24/2020

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Directions to “CARING HEART HOME HEALTHCRAE, LLC ” Practice Location

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