Healthcare Provider Details

I. General information

NPI: 1861646994
Provider Name (Legal Business Name): CUMMINGS TREASURED TIME ADULT DAY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2008
Last Update Date: 11/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22401 STATE HIGHWAY 6
DEERWOOD MN
56444-6245
US

IV. Provider business mailing address

22401 STATE HIGHWAY 6
DEERWOOD MN
56444-6245
US

V. Phone/Fax

Practice location:
  • Phone: 218-546-5071
  • Fax:
Mailing address:
  • Phone: 218-546-5071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number1051893-1-ADC
License Number StateMN

VIII. Authorized Official

Name: RACHEL J CUMMINGS
Title or Position: OWNER/DIRECTOR
Credential: RN
Phone: 218-546-5071