Organization
PERSONAL CARE ASSISTANCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FADIL JAMA RN (PRESIDENT)
(616) 634-1297
Entity
Organization
Contact information
Practice address
2355 HIGHWAY 36 W # 481, SAINT PAUL, MN 55113-3902
(616) 634-1297
(651) 393-4373
Mailing address
1610 COUNTY ROAD B W APT 1, ROSEVILLE, MN 55113-4019
(616) 634-1297
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A759128300
—
MN
05
—
A820658000
—
MN
Enumeration date
09/10/2021
Last updated
09/22/2023
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