MEDICARE: PATRICIA HEALTH CARE 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	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1891649042
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATRICIA HEALTH CARE SERVICES LLC

Provider Business Mailing Address
First Line	:	1351 GRESHAM AVE N
Second Line	:
City	:	OAKDALE
State	:	MN
Zip	:	55128-5815
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1351 GRESHAM AVE N
Second Line	:
City	:	OAKDALE
State	:	MN
Zip	:	55128-5815
Country	:	US
Telephone Number	:	267-361-9495
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	PATRICIA UMOERA
Credential	:
Telephone Number	:	267-361-9495

Provider Enumeration Date	:	02/24/2026
Last Update Date	:	02/24/2026

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