MEDICARE: UNIVITA NURSING MANAGEMENT SERVICES 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	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1669708376
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVITA NURSING MANAGEMENT SERVICES LLC

Provider Business Mailing Address
First Line	:	11000 PRAIRIE LAKES DR
Second Line	:	SUITE 600
City	:	EDEN PRAIRIE
State	:	MN
Zip	:	55344-3885
Country	:	US
Telephone Number	:	952-516-6800
Fax Number	:

Provider Business Practice Location Address
First Line	:	3700 COMMERCE PKWY
Second Line	:	SUITE A
City	:	MIRAMAR
State	:	FL
Zip	:	33025-3912
Country	:	US
Telephone Number	:	952-516-6800
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT AND TREASURER
Name	:	MR. JEFF SJOBECK
Credential	:
Telephone Number	:	952-516-6800

Provider Enumeration Date	:	10/30/2009
Last Update Date	:	05/24/2010

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