Healthcare Provider Details

I. General information

NPI: 1225379126
Provider Name (Legal Business Name): EMPIRE CARE SYSTEMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2013
Last Update Date: 07/06/2020
Certification Date: 07/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6248 LAKELAND AVE N STE 208
BROOKLYN PARK MN
55428-2989
US

IV. Provider business mailing address

6248 LAKELAND AVE N STE 208
BROOKLYN PARK MN
55428-2989
US

V. Phone/Fax

Practice location:
  • Phone: 763-225-7396
  • Fax: 877-649-1831
Mailing address:
  • Phone: 763-225-7396
  • Fax: 877-649-1831

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number383894
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number383894
License Number StateMN
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number383894
License Number StateMN

VIII. Authorized Official

Name: LEILANI FRANCELLA FLEMISTER
Title or Position: CEO
Credential: LPN,AAS,BSC.,MBA
Phone: 763-225-7396