Healthcare Provider Details

I. General information

NPI: 1114631116
Provider Name (Legal Business Name): BETTER CHOICES BETTER COMMUNITIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2023
Last Update Date: 01/13/2023
Certification Date: 01/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1002 JESSIE ST
SAINT PAUL MN
55130-3942
US

IV. Provider business mailing address

1002 JESSIE ST
SAINT PAUL MN
55130-3942
US

V. Phone/Fax

Practice location:
  • Phone: 612-364-7592
  • Fax:
Mailing address:
  • Phone: 612-364-7592
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code177F00000X
TaxonomyLodging Provider
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: NATASHA ROSE BENNETT
Title or Position: MANAGER
Credential:
Phone: 612-364-7592