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General NPI Number Information
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NPI Number | 1730569484
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Entity Type | Organization
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Legal Business Name | DIGNIFIED CHOICE CARE
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Dates
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Enumeration Date | 06/08/2015
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Last Update Date | 06/08/2015
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Provider Practice Location Address
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Address Line | 2004 RIVER HILLS DR
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City | BURNSVILLE
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State | MN
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Zip | 55337-1183
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Country | US
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Telephone | 952-392-8868
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Fax |
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Provider Business Mailing Address
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Address Line | 2004 RIVER HILLS DRIVE
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City | BURNSVILLE
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State | MN
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Zip | 55337
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Country | US
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Telephone | 719-201-3843
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Fax |
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Authorized Official
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Title or Position | COTA/OWNER
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Name | CHARLOTTE C SWANSON
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Credential |
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Telephone | 952-392-8868
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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 | 367698
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License Number State | MN
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