MEDICARE: TWIN CITIES RECUPERATIVE SERVICES LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251B00000X	Case Management Agency
2	310400000X	Assisted Living Facility
3	385H00000X	Respite Care
4	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1972398642
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TWIN CITIES RECUPERATIVE SERVICES LLC

Provider Business Mailing Address
First Line	:	2340 132ND LN NW
Second Line	:
City	:	COON RAPIDS
State	:	MN
Zip	:	55448-2570
Country	:	US
Telephone Number	:	763-447-5873
Fax Number	:

Provider Business Practice Location Address
First Line	:	2340 132ND LN NW
Second Line	:
City	:	COON RAPIDS
State	:	MN
Zip	:	55448-2570
Country	:	US
Telephone Number	:	763-447-5873
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JANET M OBONYO
Credential	:	APRN
Telephone Number	:	763-447-5873

Provider Enumeration Date	:	04/11/2025
Last Update Date	:	04/11/2025

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