Organization
MINNESOTA LIFE CARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN TARLEY (PRESIDENT)
(763) 560-8995
Entity
Organization
Contact information
Practice address
5280 ANNAPOLIS LN N, PLYMOUTH, MN 55446-3614
(763) 577-1501
(763) 577-1502
Mailing address
7710 BROOKLYN BLVD, BROOKLYN PARK, MN 55443-2979
(763) 560-9643
(763) 560-9720
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
335308
MN
Other
Enumeration date
03/28/2007
Last updated
08/22/2020
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