Organization
DIS-GENERATION GROUP INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEOFFREY IFEANYI IWUCHUKWU (CEO)
(763) 443-7434
Entity
Organization
Contact information
Practice address
6617 QUEBEC AVE N, BROOKLYN PARK, MN 55428-2234
(763) 232-1747
(763) 315-3020
Mailing address
9032 PRESTWICK PKWY N, BROOKLYN PARK, MN 55443-3946
(763) 232-1747
(763) 315-3020
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
379622
MN
253Z00000X
In Home Supportive Care Agency
Primary
379622
MN
Other
Enumeration date
12/29/2016
Last updated
03/10/2017
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