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General NPI Number Information
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NPI Number | 1376169003
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Entity Type | Organization
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Legal Business Name | YUFANYI HOLDING GROUP LLC PARAMOUNT CARE
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Dates
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Enumeration Date | 06/18/2020
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Last Update Date | 07/27/2020
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Provider Practice Location Address
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Address Line | 12041 78TH ST NE
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City | OTSEGO
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State | MN
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Zip | 55330-4822
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Country | US
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Telephone | 612-636-3800
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Fax | 763-777-9044
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Provider Business Mailing Address
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Address Line | 12041 78TH ST NE
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City | OTSEGO
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State | MN
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Zip | 55330-4822
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Country | US
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Telephone | 612-636-3800
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Fax | 763-777-9044
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Authorized Official
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Title or Position | PRESIDENT/MANAGING EMPLOYEE
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Name | JOHN CTSIAMBU YUFANYI
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Credential | RN,BSN
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Telephone | 612-636-3800
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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