MEDICARE: EARLY DEVELOPMENT CARE 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
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1669130795
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EARLY DEVELOPMENT CARE LLC

Provider Business Mailing Address
First Line	:	7835 3RD ST N STE 108
Second Line	:
City	:	OAKDALE
State	:	MN
Zip	:	55128-5445
Country	:	US
Telephone Number	:	612-703-8892
Fax Number	:

Provider Business Practice Location Address
First Line	:	7835 3RD ST N STE 108
Second Line	:
City	:	OAKDALE
State	:	MN
Zip	:	55128-5445
Country	:	US
Telephone Number	:	612-703-8892
Fax Number	:	651-666-1268

Authorized Official
Title or Position	:	OWNER
Name	:	SAFIO XAJI
Credential	:
Telephone Number	:	612-703-8892

Provider Enumeration Date	:	12/06/2021
Last Update Date	:	11/12/2025

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