Healthcare Provider Details

I. General information

NPI: 1689815128
Provider Name (Legal Business Name): CAREMERIDIAN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2009
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2792 E ALLUVIAL AVE
FRESNO CA
93720-9104
US

IV. Provider business mailing address

6600 FRANCE AVE S STE 350
EDINA MN
55435-1810
US

V. Phone/Fax

Practice location:
  • Phone: 800-388-5150
  • Fax:
Mailing address:
  • Phone: 952-922-6776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number55000897
License Number StateCA

VIII. Authorized Official

Name: MARY PATRICIA RODENBERG-ROBERTS
Title or Position: VP & SR ASST GENERAL COUNSEL
Credential:
Phone: 952-836-2234