Healthcare Provider Details

I. General information

NPI: 1043486616
Provider Name (Legal Business Name): UNIQUE HEALTH CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2008
Last Update Date: 05/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2935 FREEMAN AVE S APT#111
MPLS MN
55408
US

IV. Provider business mailing address

7420 UNITY AVE N SUITE#310C
BROOKLYN PARK MN
55443-3143
US

V. Phone/Fax

Practice location:
  • Phone: 763-221-7656
  • Fax: 763-566-4930
Mailing address:
  • Phone: 763-503-5072
  • Fax: 763-566-4930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number251J00000X
License Number StateMN

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: WESLEY YAIDOO
Title or Position: ADMINISTRATOR
Credential:
Phone: 763-221-7656