Healthcare Provider Details

I. General information

NPI: 1578323309
Provider Name (Legal Business Name): DEPENDABLE HOME CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2024
Last Update Date: 03/20/2024
Certification Date: 03/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3931 30TH AVE S
FARGO ND
58104-7799
US

IV. Provider business mailing address

3931 30TH AVE S
FARGO ND
58104-7799
US

V. Phone/Fax

Practice location:
  • Phone: 701-491-2220
  • Fax:
Mailing address:
  • Phone: 701-491-2220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MAIMA JAMES
Title or Position: ADMINISTRATOR
Credential:
Phone: 703-491-2220