Organization
ADVANCED CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VICTOR OGBUEHI (ADMINISTRATOR)
(612) 721-1957
Entity
Organization
Contact information
Practice address
1415 PARK AVE S, MINNEAPOLIS, MN 55404
(612) 721-1957
Mailing address
1415 PARK AVE S, MINNEAPOLIS, MN 55404
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
067545800
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
067545800
—
MN
01
—
1021138-2-WS
245B WAIVERED SERVICES
MN
Enumeration date
08/19/2006
Last updated
10/22/2019
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