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General NPI Number Information
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NPI Number | 1194881235
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Entity Type | Organization
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Legal Business Name | RELIEVE CARE
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Dates
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Enumeration Date | 12/30/2006
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Last Update Date | 03/27/2017
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Provider Practice Location Address
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Address Line | 11490 HANSON BLVD NW SUITE A
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City | COON RAPIDS
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State | MN
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Zip | 55433-3978
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Country | US
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Telephone | 763-757-3207
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Fax | 763-780-5700
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Provider Business Mailing Address
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Address Line | 11490 HANSON BLVD NW SUITE A
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City | COON RAPIDS
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State | MN
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Zip | 55433-3978
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Country | US
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Telephone | 763-757-3207
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Fax | 763-780-5700
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Authorized Official
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Title or Position | BUSINESS AFFAIRS DIRECTOR
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Name | MRS. LARA FATUNBI
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Credential |
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Telephone | 763-757-3207
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 8090899
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License Number State | MN
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