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General NPI Number Information
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NPI Number | 1558745901
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Entity Type | Organization
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Legal Business Name | ELDER CARE DAY SERVICES, LLC
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Dates
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Enumeration Date | 07/16/2015
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Last Update Date | 01/06/2022
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Provider Practice Location Address
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Address Line | 1774 COPE AVE.
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City | MAPLEWOOD
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State | MN
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Zip | 55109
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Country | US
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Telephone | 651-734-3913
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Fax | 651-440-9118
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Provider Business Mailing Address
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Address Line | 1774 COPE AVE.
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City | MAPLEWOOD
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State | MN
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Zip | 55109
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Country | US
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Telephone | 651-734-3913
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Fax | 651-440-9118
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Authorized Official
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Title or Position | OWNER / CENTER COORDINATOR
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Name | SOUK HER
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Credential |
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Telephone | 651-734-3913
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | 1076075
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | 1076075
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License Number State | MN
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