Healthcare Provider Details

I. General information

NPI: 1801011770
Provider Name (Legal Business Name): KAYCEE'S HOME CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3980 16TH ST SO. APT. 109
MOORHEAD MN
56560
US

IV. Provider business mailing address

PO BOX 421
MOORHEAD MN
56561
US

V. Phone/Fax

Practice location:
  • Phone: 218-731-4062
  • Fax:
Mailing address:
  • Phone: 218-731-4062
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number333675
License Number StateMN

VIII. Authorized Official

Name: MS. DOROTHY LEA FIEDLER
Title or Position: OWNER/OPERATOR
Credential:
Phone: 218-731-4062