MEDICARE: HOPECARE PCA, INC

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	251E00000X	Home Health Agency		MN
2	251E00000X	Home Health Agency	A236480100	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	A236480100	OTHER	MN	DHS-UMPI

General Provider Information

NPI Number	:	1972757227
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOPECARE PCA, INC

Provider Business Mailing Address
First Line	:	7710 BROOKLYN BLVD
Second Line	:	SUITE 109
City	:	BROOKLYN PARK
State	:	MN
Zip	:	55443-2699
Country	:	US
Telephone Number	:	763-566-6066
Fax Number	:	763-566-5577

Provider Business Practice Location Address
First Line	:	7710 BROOKLYN BLVD
Second Line	:	SUITE 109
City	:	BROOKLYN PARK
State	:	MN
Zip	:	55443-2699
Country	:	US
Telephone Number	:	763-566-6066
Fax Number	:	763-566-5577

Authorized Official
Title or Position	:	OWNER
Name	:	SHEREE MIA STEELE
Credential	:
Telephone Number	:	763-566-6066

Provider Enumeration Date	:	11/13/2008
Last Update Date	:	03/21/2013

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