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General NPI Number Information
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NPI Number | 1790998334
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Entity Type | Organization
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Legal Business Name | OMETTA VENT CARE SERVICES, INC
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3140 HARBOR LN N STE 250
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City | PLYMOUTH
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State | MN
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Zip | 55447-5126
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Country | US
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Telephone | 763-551-1123
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Fax | 763-551-1109
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Provider Business Mailing Address
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Address Line | 3140 HARBOR LN N STE 250
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City | PLYMOUTH
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State | MN
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Zip | 55447-5126
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Country | US
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Telephone | 763-551-1123
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Fax | 763-551-1109
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Authorized Official
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Title or Position | CEO
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Name | MISS BARBARA ANN CURRIN
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Credential | LPN
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Telephone | 763-551-1123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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