# DIS-GENERATION GROUP INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871038828
- **Authorized official:** MR. GEOFFREY IFEANYI IWUCHUKWU (CEO)
- **Authorized official phone:** (763) 443-7434

## Contact information

- **Practice address:** 6617 QUEBEC AVE N, BROOKLYN PARK, MN 55428-2234
- **Practice address phone:** (763) 232-1747
- **Practice address fax:** (763) 315-3020
- **Mailing address:** 9032 PRESTWICK PKWY N, BROOKLYN PARK, MN 55443-3946
- **Mailing address phone:** (763) 232-1747
- **Mailing address fax:** (763) 315-3020

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 379622 | MN | — |
| 253Z00000X | In Home Supportive Care Agency | 379622 | MN | Yes |

## Other

- **Enumeration date:** 12/29/2016
- **Last updated:** 03/10/2017