MEDICARE: DANIEL CARE HOMES LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	253J00000X	Foster Care Agency
2	310400000X	Assisted Living Facility
3	311ZA0620X	Adult Care Home Facility

General Provider Information

NPI Number	:	1679189682
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DANIEL CARE HOMES LLC

Provider Business Mailing Address
First Line	:	7819 MACKENZIE AVE NE
Second Line	:
City	:	OTSEGO
State	:	MN
Zip	:	55330-5037
Country	:	US
Telephone Number	:	763-321-9729
Fax Number	:

Provider Business Practice Location Address
First Line	:	6809 PERRY AVE N
Second Line	:
City	:	BROOKLYN CENTER
State	:	MN
Zip	:	55429-1611
Country	:	US
Telephone Number	:	203-449-6079
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	EMELIE NGOY
Credential	:
Telephone Number	:	763-321-9729

Provider Enumeration Date	:	09/16/2020
Last Update Date	:	12/27/2024

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Directions to “DANIEL CARE HOMES LLC ” Practice Location

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