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General NPI Number Information
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NPI Number | 1780684712
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Entity Type | Organization
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Legal Business Name | HEALTHWORKS PCA, INC
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Dates
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Enumeration Date | 08/01/2005
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Last Update Date | 12/21/2007
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Provider Practice Location Address
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Address Line | 1895 WEST COUNTY RD C
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City | ROSEVILLE
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State | MN
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Zip | 55113-1304
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Country | US
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Telephone | 651-209-0591
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Fax | 651-209-8877
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Provider Business Mailing Address
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Address Line | 1895 COUNTY ROAD C
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City | ROSEVILLE
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State | MN
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Zip | 55113-1304
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Country | US
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Telephone | 651-209-0591
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Fax | 651-209-8877
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Authorized Official
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Title or Position | MANAGER
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Name | MS. PAULA JEAN BARRON
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Credential |
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Telephone | 651-209-0591
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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 | 2821451
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License Number State | MN
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