Healthcare Provider Details

I. General information

NPI: 1932963337
Provider Name (Legal Business Name): DYNAMIC CARE SOLUTION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2024
Last Update Date: 02/07/2024
Certification Date: 02/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1375 SAINT ANTHONY AVE # 202-6
SAINT PAUL MN
55104-4006
US

IV. Provider business mailing address

1375 SAINT ANTHONY AVE # 202-6
SAINT PAUL MN
55104-4006
US

V. Phone/Fax

Practice location:
  • Phone: 651-368-7566
  • Fax:
Mailing address:
  • Phone: 651-368-7566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MOHAMEDAMIN SHARIF
Title or Position: CEO
Credential:
Phone: 651-368-7566