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NPI Code Detail

MEDICARE: NORTH RIDGE ADULT DAY CARE LLC

MEDICARE: NORTH RIDGE ADULT DAY CARE 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
1261QA0600XAdult Day Care Clinic/Center

General Provider Information

NPI Number : 1326696832
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTH RIDGE ADULT DAY CARE LLC
Provider Business Mailing Address
First Line : 5430 BOONE AVE N
Second Line :
City : NEW HOPE
State : MN
Zip : 55428-3615
Country : US
Telephone Number : 763-592-3000
Fax Number : 763-592-2999
Provider Business Practice Location Address
First Line : 5430 BOONE AVE N
Second Line :
City : NEW HOPE
State : MN
Zip : 55428-3615
Country : US
Telephone Number : 763-592-3000
Fax Number : 763-592-2999
Authorized Official
Title or Position : CFO
Name : MICHELLE M DELKER
Credential :
Telephone Number : 813-321-1239
Provider Enumeration Date : 08/28/2019
Last Update Date : 08/28/2019

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Directions to “NORTH RIDGE ADULT DAY CARE LLC ” Practice Location

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