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General NPI Number Information
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NPI Number | 1689497026
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Entity Type | Organization
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Legal Business Name | ADVOCATE HEALTHCARE SERVICES
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Dates
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Enumeration Date | 11/04/2024
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Last Update Date | 04/10/2025
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Provider Practice Location Address
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Address Line | 17910 28TH AVE N
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City | PLYMOUTH
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State | MN
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Zip | 55447-1625
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Country | US
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Telephone | 763-317-0563
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Fax | 763-205-8871
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Provider Business Mailing Address
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Address Line | 17910 28TH AVE N
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City | PLYMOUTH
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State | MN
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Zip | 55447-1625
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Country | US
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Telephone | 651-410-9126
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Fax |
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Authorized Official
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Title or Position | CEO AND ADMINISTRATOR
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Name | MR. KENNETH KASONGO CHOWA
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Credential |
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Telephone | 651-410-9126
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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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 | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number |
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License Number State |
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