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General NPI Number Information
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NPI Number | 1235360637
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Entity Type | Organization
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Legal Business Name | WICARE HOMECARE SERVICES
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Dates
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Enumeration Date | 08/03/2009
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Last Update Date | 02/06/2017
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Provider Practice Location Address
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Address Line | 1885 UNIVERSITY AVE W SUIT#300B
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City | ST PAUL
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State | MN
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Zip | 55104
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Country | US
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Telephone | 651-738-4890
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Fax | 651-846-6530
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Provider Business Mailing Address
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Address Line | 1885 UNIVERSITY AVE W STE 300B
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City | SAINT PAUL
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State | MN
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Zip | 55104-3462
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Country | US
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Telephone | 651-738-4890
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Fax | 651-846-6530
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. DOROTHY MBABAZI MICHORI
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Credential |
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Telephone | 651-738-4890
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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 | 343327
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License Number State | MN
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