Organization
DIRECTIONS FOR LIFE PCA SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS CHRISTINE MEILACH (EXECUTIVE PROGRAM COORDINATOR, QMRP)
(218) 722-1184
Entity
Organization
Contact information
Practice address
4897 MILLER TRUNK HWY, HERMANTOWN, MN 55811-1586
(218) 722-1184
(218) 722-7148
Mailing address
4897 MILLER TRUNK HWY, HERMANTOWN, MN 55811-1586
(218) 722-1184
(218) 722-7148
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A111290200
—
MN
Enumeration date
06/09/2009
Last updated
06/09/2009
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