Healthcare Provider Details

I. General information

NPI: 1477530459
Provider Name (Legal Business Name): NOVACARE REHABILITATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6515 BARRIE RD SUITE 100
EDINA MN
55435-2305
US

IV. Provider business mailing address

6515 BARRIE RD SUITE 100
EDINA MN
55435-2305
US

V. Phone/Fax

Practice location:
  • Phone: 952-922-5019
  • Fax: 952-922-1384
Mailing address:
  • Phone: 952-922-5019
  • Fax: 952-922-1384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number
License Number StateMN

VIII. Authorized Official

Name: MRS. DARLYN FAYE MUETZEL
Title or Position: ADMINISTRATIVE MANAGER
Credential:
Phone: 763-450-2001