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NPI Code Detail

MEDICARE: CAREGIVER MN, LLC

MEDICARE: CAREGIVER MN, 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
1320900000XIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number : 1497488381
Entity Type Code : Organization
Provider Name (Legal Business Name) : CAREGIVER MN, LLC
Provider Business Mailing Address
First Line : 4800 OVERTON PLZ STE 440
Second Line :
City : FORT WORTH
State : TX
Zip : 76109-4435
Country : US
Telephone Number : 800-299-5161
Fax Number : 817-447-3033
Provider Business Practice Location Address
First Line : 4800 OVERTON PLZ STE 440
Second Line :
City : FORT WORTH
State : TX
Zip : 76109-4435
Country : US
Telephone Number : 800-299-5161
Fax Number : 817-447-3033
Authorized Official
Title or Position : OPERATIONS BUSINESS MANAGER
Name : ANNA TODD
Credential :
Telephone Number : 800-299-5161
Provider Enumeration Date : 07/07/2022
Last Update Date : 07/07/2022

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Directions to “CAREGIVER MN, LLC ” Practice Location

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