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General NPI Number Information
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NPI Number | 1861628455
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Entity Type | Organization
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Legal Business Name | DIRECTIONS FOR LIFE PCA SERVICES
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Dates
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Enumeration Date | 06/09/2009
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Last Update Date | 06/09/2009
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Provider Practice Location Address
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Address Line | 4897 MILLER TRUNK HWY
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City | HERMANTOWN
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State | MN
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Zip | 55811-1586
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Country | US
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Telephone | 218-722-1184
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Fax | 218-722-7148
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Provider Business Mailing Address
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Address Line | 4897 MILLER TRUNK HWY
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City | HERMANTOWN
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State | MN
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Zip | 55811-1586
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Country | US
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Telephone | 218-722-1184
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Fax | 218-722-7148
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Authorized Official
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Title or Position | EXECUTIVE PROGRAM COORDINATOR, QMRP
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Name | MISS CHRISTINE MEILACH
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Credential |
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Telephone | 218-722-1184
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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