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General NPI Number Information
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NPI Number | 1548961725
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Entity Type | Organization
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Legal Business Name | CK QUALITY HOME CARE CORPORATION
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Dates
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Enumeration Date | 03/14/2023
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Last Update Date | 03/14/2023
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Provider Practice Location Address
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Address Line | 2415 ANNAPOLIS LN N STE 100
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City | PLYMOUTH
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State | MN
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Zip | 55441-3651
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Country | US
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Telephone | 952-395-3443
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Fax | 952-214-4030
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Provider Business Mailing Address
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Address Line | 5790 BRENTRIDGE DR
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City | EXCELSIOR
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State | MN
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Zip | 55331-8300
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Country | US
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Telephone | 952-395-3443
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Fax | 952-214-4030
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Authorized Official
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Title or Position | PRESIDENT
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Name | KAITLIN MCDANIEL
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Credential |
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Telephone | 847-302-6486
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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