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General NPI Number Information
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NPI Number | 1235388810
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Entity Type | Organization
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Legal Business Name | DISCOVERY HOME CARE INC.
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Dates
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Enumeration Date | 09/18/2008
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Last Update Date | 09/18/2008
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Provider Practice Location Address
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Address Line | 8363 W 149TH ST
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City | SAVAGE
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State | MN
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Zip | 55378-4714
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Country | US
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Telephone | 952-888-0003
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Fax | 952-888-1176
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Provider Business Mailing Address
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Address Line | 8363 W 149TH ST
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City | SAVAGE
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State | MN
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Zip | 55378-4714
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Country | US
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Telephone | 952-888-0003
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Fax | 952-888-1176
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. WYCLIFFE MOKAYA
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Credential | RN
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Telephone | 612-590-2733
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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 | 340259
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License Number State | MN
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