Healthcare Provider Details

I. General information

NPI: 1033440490
Provider Name (Legal Business Name): A BETTER LIVING CARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2010
Last Update Date: 01/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13792 HILL PLACE DR
ROGERS MN
55374-9582
US

IV. Provider business mailing address

13792 HILL PLACE DR
ROGERS MN
55374-9582
US

V. Phone/Fax

Practice location:
  • Phone: 763-245-8682
  • Fax:
Mailing address:
  • Phone: 763-245-8682
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number347631
License Number StateMN

VIII. Authorized Official

Name: MRS. JANE MICHOMA
Title or Position: PRESIDENT
Credential:
Phone: 763-245-8682