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General NPI Number Information
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NPI Number | 1518485226
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Entity Type | Organization
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Legal Business Name | ACCRA CARE
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Dates
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Enumeration Date | 09/01/2017
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Last Update Date | 07/06/2022
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Provider Practice Location Address
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Address Line | 12600 WHITEWATER DR STE 100
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City | MINNETONKA
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State | MN
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Zip | 55343-9450
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Country | US
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Telephone | 952-935-3515
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Fax | 952-935-7112
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Provider Business Mailing Address
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Address Line | 12600 WHITEWATER DR STE 100
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City | MINNETONKA
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State | MN
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Zip | 55343-9450
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Country | US
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Telephone | 952-935-3515
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Fax | 952-935-7112
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Authorized Official
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Title or Position | CFO
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Name | LEANN FRETTE
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Credential |
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Telephone | 952-935-3515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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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 | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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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 | 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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