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General NPI Number Information
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NPI Number | 1063301703
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Entity Type | Organization
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Legal Business Name | ADVANCE CARE SERVICES CORPORATION
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Dates
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Enumeration Date | 06/30/2025
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Last Update Date | 10/11/2025
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Provider Practice Location Address
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Address Line | 63 LANGER CIR
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City | WEST SAINT PAUL
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State | MN
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Zip | 55118-2138
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Country | US
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Telephone | 651-246-2589
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Fax |
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Provider Business Mailing Address
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Address Line | 6060 INSKIP BAY S.
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City | COTTAGE GROVE
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State | MN
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Zip | 55016
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Country | US
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Telephone | 651-246-2589
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Fax |
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Authorized Official
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Title or Position | OWNER/EXECUTIVE DIRECTOR
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Name | DR. OLUWOLE AYODEJI ADEREMI-ATA
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Credential | PHD
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Telephone | 651-246-2589
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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