Organization
WICARE HOMECARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DOROTHY MBABAZI MICHORI (PRESIDENT)
(651) 738-4890
Entity
Organization
Contact information
Practice address
1885 UNIVERSITY AVE W SUIT#300B, ST PAUL, MN 55104
(651) 738-4890
(651) 846-6530
Mailing address
1885 UNIVERSITY AVE W STE 300B, SAINT PAUL, MN 55104-3462
(651) 738-4890
(651) 846-6530
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
343327
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A156483100
STRAIGHT MEDICARE
MN
01
—
A760018300
STRAIGHT MEDICARE(MA)
MN
Enumeration date
08/03/2009
Last updated
02/06/2017
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