=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184046963
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CAREGIVERS MAKING A DIFFERENCE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/13/2014
-----------------------------------------------------
Last Update Date | 04/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1879 STATION PKWY NW
-----------------------------------------------------
City | ANDOVER
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55304-4880
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 763-205-4440
-----------------------------------------------------
Fax | 763-205-4403
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1879 STATION PKWY NW
-----------------------------------------------------
City | ANDOVER
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55304-4880
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 763-205-4440
-----------------------------------------------------
Fax | 763-205-4403
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. BRIAN MICHAEL MCDONALD
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 763-205-4440
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WH0200X
-----------------------------------------------------
Taxonomy Name | Home Health Registered Nurse
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number | 363457
-----------------------------------------------------
License Number State | MN
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 3747P1801X
-----------------------------------------------------
Taxonomy Name | Personal Care Attendant
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 374U00000X
-----------------------------------------------------
Taxonomy Name | Home Health Aide
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #5
-----------------------------------------------------
Taxonomy Code | 376J00000X
-----------------------------------------------------
Taxonomy Name | Homemaker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #6
-----------------------------------------------------
Taxonomy Code | 376K00000X
-----------------------------------------------------
Taxonomy Name | Nurse's Aide
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #7
-----------------------------------------------------
Taxonomy Code | 385H00000X
-----------------------------------------------------
Taxonomy Name | Respite Care
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #8
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------