Healthcare Provider Details

I. General information

NPI: 1275181307
Provider Name (Legal Business Name): CHARITY CARE INC PROFESSIONAL SERVICE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2019
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2816 92ND CRES N
BROOKLYN PARK MN
55443-1743
US

IV. Provider business mailing address

2816 92ND CRES N 2816 92ND CRES N
BROOKLYN PARK MN
55443-1743
US

V. Phone/Fax

Practice location:
  • Phone: 612-273-6110
  • Fax:
Mailing address:
  • Phone: 763-273-6110
  • Fax: 763-312-2278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: CHARITY NYAMISA ONGERI
Title or Position: OWNER
Credential:
Phone: 612-273-6110