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General NPI Number Information
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NPI Number | 1942813407
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Entity Type | Organization
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Legal Business Name | UNITED CARE SERVICES
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Dates
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Enumeration Date | 08/25/2020
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Last Update Date | 01/15/2025
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Provider Practice Location Address
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Address Line | 1310 HIGHWAY 96 EAST SUITE 204A
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City | WHITE BEAR LAKE
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State | MN
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Zip | 55110-3619
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Country | US
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Telephone | 651-334-5427
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Fax | 651-305-4086
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Provider Business Mailing Address
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Address Line | 1310 HIGHWAY 96 EAST SUITE 204A
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City | WHITE BEAR LAKE
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State | MN
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Zip | 55110-3619
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Country | US
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Telephone | 651-334-5427
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Fax | 651-305-4086
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Authorized Official
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Title or Position | PRESIDENT
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Name | PANGDA OLIVIA LEE
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Credential |
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Telephone | 651-334-5427
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251T00000X
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Taxonomy Name | PACE Provider Organization
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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