Healthcare Provider Details

I. General information

NPI: 1003593815
Provider Name (Legal Business Name): ALEDICT HEALTH CARE AGENCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2023
Last Update Date: 12/04/2023
Certification Date: 12/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4124 QUEBEC AVE N STE 302C
NEW HOPE MN
55427-1241
US

IV. Provider business mailing address

4124 QUEBEC AVE N STE 302C
NEW HOPE MN
55427-1241
US

V. Phone/Fax

Practice location:
  • Phone: 952-955-6989
  • Fax:
Mailing address:
  • Phone: 952-955-6989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MARGARET SIEMON ALLEN
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 952-955-6989