Healthcare Provider Details

I. General information

NPI: 1942146295
Provider Name (Legal Business Name): CARETAP UT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 TWELVE OAKS CENTER DR STE 214
WAYZATA MN
55391-4548
US

IV. Provider business mailing address

600 TWELVE OAKS CENTER DR STE 214
WAYZATA MN
55391-4548
US

V. Phone/Fax

Practice location:
  • Phone: 612-438-9343
  • Fax:
Mailing address:
  • Phone: 612-438-9343
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: ABDULLAHI A JAMA
Title or Position: PRESIDENT
Credential:
Phone: 612-438-9343