=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467636084
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CARE FOR ME NURSING SERVICES INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/18/2007
-----------------------------------------------------
Last Update Date | 12/18/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2147 UNIVERSITY AVE W SUITE 211
-----------------------------------------------------
City | SAINT PAUL
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55114-1313
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 651-644-4034
-----------------------------------------------------
Fax | 651-204-0198
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2147 UNIVERSITY AVE W SUITE 211
-----------------------------------------------------
City | SAINT PAUL
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55114-1313
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 651-644-4034
-----------------------------------------------------
Fax | 651-204-0198
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | MR. CHARLIE OLAKUNLE ORIBAMISE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 651-644-4034
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251J00000X
-----------------------------------------------------
Taxonomy Name | Nursing Care Agency
-----------------------------------------------------
License Number | 335143
-----------------------------------------------------
License Number State | MN
-----------------------------------------------------