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General NPI Number Information
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NPI Number | 1407220395
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Entity Type | Organization
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Legal Business Name | HOMETOWN CARE PROVIDERS
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Dates
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Enumeration Date | 11/16/2015
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Last Update Date | 11/16/2015
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Provider Practice Location Address
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Address Line | 175 80TH AVE NE
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City | CLARA CITY
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State | MN
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Zip | 56222-1221
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Country | US
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Telephone | 320-564-3308
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Fax |
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Provider Business Mailing Address
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Address Line | 175 80TH AVE NE
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City | CLARA CITY
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State | MN
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Zip | 56222-1221
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Country | US
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Telephone | 320-564-3308
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | STEVEN TAMMEN
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Credential |
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Telephone | 507-430-6175
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 310400000X
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License Number State | MN
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