LIFE CARE PCA LLC (NPI# 1942467485) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942467485 |
| Entity Type | Organization |
| Organization Name | LIFE CARE PCA LLC |
| Practice Address |
17165 Gage Way Farmington MN 55024-9227 |
| Practice Telephone | 6518085481 |
| Practice Fax Number | 9524316160 |
| Mailing Telephone | 6518085481 |
| Mailing Fax Number | 9524316160 |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2008-05-21 |
| Authorized Official Name | MRS. KRISTINA LYN MUSA (OFFICE MANAGER) |
| Authorized Official Telephone | 6518085481 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3747P1801X |
Technician Specialization: Personal Care Attendant |
1408501-2 | MN | Nursing Service Related Providers |
| Street Address |
17165 GAGE WAY |
| City | FARMINGTON |
| State | MN |
| Zip Code | 55024-9227 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932758158 | Renetia Jackson | Technician | 1210 Spruce Street, Farmington, MN 55024 | 2019-09-10 |
| 1871094912 | Megan Provost | Registered Nurse | 17680 Formosa Ave, Farmington, MN 55024 | 2018-02-23 |
| 1356752463 | Your Vision Achieved, LLC | Marriage & Family Therapist | 5404 187th Street West, Farmington, MN 55024 | 2014-05-12 |
| 1427304203 | Joseph Samuel Emond Jr. | Family Medicine | 19730 Meadowlark Way, Farmington, MN 55024 | 2012-07-30 |
| 1053680991 | Annie Lee Mickelson | Chiropractor | 20700 Chippendale Ave Suite 7, Farmington, MN 55024 | 2011-12-21 |
| 1770770828 | Grand St Paul Cvs LLC | Durable Medical Equipment & Medical Supplies | 19605 Pilot Knob Rd., Farmington, MN 55024 | 2007-10-02 |
| 1275725277 | Family Vision Clinic of Farmington | Optometrist | 19650 Pilot Knob Road, Farmington, MN 55024 | 2007-08-14 |
| 1871503136 | Independent School District #192 | Early Intervention Provider Agency | 20655 Flagstaff Avenue, Farmington, MN 55024 | 2006-08-09 |
| 1588692669 | Northfield Hospital | Clinic/Center | 4645 Knutsen Dr, Farmington, MN 55024 | 2006-06-29 |
| 1902887284 | David E Truax | Chiropractor | 20700 Chippendale Ave, Suite 7, Farmington, MN 55024 | 2005-11-14 |
| Find all providers in zip 55024 | ||||
| Taxonomy Code | 3747P1801X |
| Grouping | Nursing Service Related Providers |
| Classification | Technician |
| Specialization | Personal Care Attendant |
| An individual who provides assistance with eating, bathing, dressing, personal hygiene, activities of daily living as specified in the plan of care. Services which are incidental to the care furnished, or essential to the health and welfare of the individual may also be provided. Personal care providers must meet state defined training and certification standards |
| Notes: [7/1/2003: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093316333 | Barbara J Dadisman | Technician | 364 Parrish Run Rd, Farmington, WV 26571-8097 | 2020-11-03 |
| 1861003667 | Norma Lucille Devericks | Technician | 173 Horseshoe Rd, Farmington, WV 26571 | 2020-08-14 |
| 1093326191 | Richard William Ours | Technician | 9 Top St, Farmington, WV 26571-7903 | 2020-08-12 |
| 1871613158 | David M Tesreau | Technician | 3719 Sand Creek Rd, Farmington, MO 63640-7349 | 2007-03-30 |
| 1336740018 | Helen K Morrison | Technician | 364 Parrish Run Rd, Farmington, WV 26571-8097 | 2020-11-08 |
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|---|---|---|---|---|
| 1245830835 | Dorothy Gomez | Technician | 622 1st Ave Ne, East Grand Forks, MN 56721-1905 | 2020-10-31 |
| 1972102457 | A1 Care Shriners At Home Services Inc. | Technician | 4665 Victor Path Unit 2, Hugo, MN 55038-6037 | 2020-10-25 |
| 1770196065 | Amina Webi | Technician | 2930 Blaisdell Ave Apt 333, Minneapolis, MN 55408-2326 | 2020-08-26 |
| 1194343269 | Khadro Abdirahman Yusuf | Technician | 1500 Nicollet Ave Apt 609, Minneapolis, MN 55403-2740 | 2020-07-06 |
| 1811511215 | Royalty Care, Inc | Technician | 46 28th Ave N Ste 46u, Saint Cloud, MN 56303-4241 | 2020-06-01 |
| 1245853506 | Julie Ann Milnler | Technician | 17520 93rd Pl N, Maple Grove, MN 55311-4434 | 2020-05-21 |
| 1932729704 | Owegio Wreh | Technician | 1405 Silver Lake Road Suite 15, New Brighton, MN 55112 | 2020-04-22 |
| 1053946632 | Lovingcare Nursing & Home Care Services, Inc. | Technician | 1152 Robert St S, West St Paul, MN 55118-2315 | 2020-03-04 |
| 1982238085 | Jerald Haley | Technician | 924 6th Ave. S., Stillwater, MN 55082 | 2020-02-27 |
| 1336773522 | Hiedi Philstrom | Technician | 56656 Stephanie Ln, Pine City, MN 55063-9095 | 2020-02-26 |
| Find all providers with the same taxonomy | ||||
| City | FARMINGTON |
| Zip Code | 55024 |
Please comment or provide details below to improve the information on LIFE CARE PCA LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.