Healthcare Provider Details

I. General information

NPI: 1518285899
Provider Name (Legal Business Name): HELPING SENIORS IN MINNESOTA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2010
Last Update Date: 05/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14565 41ST AVE N
PLYMOUTH MN
55446-2749
US

IV. Provider business mailing address

14565 41ST AVE N
PLYMOUTH MN
55446-2749
US

V. Phone/Fax

Practice location:
  • Phone: 763-694-0165
  • Fax:
Mailing address:
  • Phone: 763-694-0165
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: SANDRA NICCUM
Title or Position: OWNER
Credential:
Phone: 612-203-9710