Healthcare Provider Details

I. General information

NPI: 1659991545
Provider Name (Legal Business Name): BELONG HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2020
Last Update Date: 04/20/2020
Certification Date: 04/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4809 OXBOROUGH GDNS
BROOKLYN PARK MN
55443-3993
US

IV. Provider business mailing address

16346 70TH AVE N
MAPLE GROVE MN
55311-2960
US

V. Phone/Fax

Practice location:
  • Phone: 267-980-6520
  • Fax:
Mailing address:
  • Phone: 267-980-6520
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: FRANCES DECONTEE THIAM
Title or Position: ADMINISTRATOR
Credential:
Phone: 267-980-6520