MEDICARE: CRAIG RESOURCES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251J00000X	Nursing Care Agency
2	385H00000X	Respite Care
3	251E00000X	Home Health Agency	0009412	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0009412	OTHER	MO	MISSOURI SSBG/GR PROVIDER

General Provider Information

NPI Number	:	1003088998
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRAIG RESOURCES LLC

Provider Business Mailing Address
First Line	:	2800 CLEVELAND AVE N
Second Line	:
City	:	ROSEVILLE
State	:	MN
Zip	:	55113-1126
Country	:	US
Telephone Number	:	651-642-1825
Fax Number	:	651-638-0680

Provider Business Practice Location Address
First Line	:	11116 S TOWNE SQ STE 101
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63123-7809
Country	:	US
Telephone Number	:	314-843-0316
Fax Number	:	314-843-0337

Authorized Official
Title or Position	:	VP OF QUALITY AND COMPLIANCE
Name	:	MR. CAMEO ZEHNDER
Credential	:
Telephone Number	:	651-642-1825

Provider Enumeration Date	:	03/31/2008
Last Update Date	:	06/17/2026

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Directions to “CRAIG RESOURCES LLC ” Practice Location

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