Organization
MARY R. SENIOR CARE & HOME CARE SERVICES AGENCY LLC
Active
Other names
Mary R. Senior Care & Home Care Services Agency LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DININA DAVIS RN (PRESIDENT/OWNER)
(952) 688-9499
Entity
Organization
Contact information
Practice address
1615 S 4TH ST APT M3306, MINNEAPOLIS, MN 55454-1364
(952) 688-9499
Mailing address
1615 S 4TH ST APT M3306, MINNEAPOLIS, MN 55454-1364
(952) 688-9499
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720654056
—
MN
Enumeration date
06/09/2021
Last updated
07/06/2021
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