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NPI 1780283044

NPI 1780283044 : TC HEALTHCARE : PLYMOUTH, MN

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General NPI Number Information
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    NPI Number           |    1780283044
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    Entity Type          |    Organization 
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    Legal Business Name  |    TC HEALTHCARE 
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Dates
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    Enumeration Date     |    10/19/2020
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    Last Update Date     |    10/19/2020
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Provider Practice Location Address
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    Address Line         |    505 HIGHWAY 169 N STE 255 
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    City                 |    PLYMOUTH
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    State                |    MN
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    Zip                  |    55441-6463
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    Country              |    US
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    Telephone            |    612-877-1359
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    505 HIGHWAY 169 N STE 255 
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    City                 |    PLYMOUTH
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    State                |    MN
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    Zip                  |    55441-6463
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    Country              |    US
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    Telephone            |    612-877-1359
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CEO
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    Name                 |     JAMES P KENT 
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    Credential           |    
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    Telephone            |    612-877-1359
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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