Organization
HOMECARE RESOURCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARIE L DEVOLITES (PRESIDENT)
(952) 854-6104
Entity
Organization
Contact information
Practice address
900 AMERICAN BLVD E, SUITE 100, BLOOMINGTON, MN 55420-1392
(952) 854-6104
Mailing address
900 AMERICAN BLVD E, SUITE 100, BLOOMINGTON, MN 55420-1392
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
332246
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1841484300
NPI
MN
05
—
682678400
—
MN
05
—
96602900
—
MN
Enumeration date
12/07/2010
Last updated
12/07/2010
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