Healthcare Provider Details

I. General information

NPI: 1255833836
Provider Name (Legal Business Name): USCARE HOMECARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2018
Last Update Date: 05/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 BENSON AVE SW
WILLMAR MN
56201-3235
US

IV. Provider business mailing address

400 LITCHFIELD AVE SW
WILLMAR MN
56201-3242
US

V. Phone/Fax

Practice location:
  • Phone: 320-210-1234
  • Fax:
Mailing address:
  • Phone: 320-210-1234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ABDIRAHMAN ABDI
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 320-214-1234