1942440441 NPI number — CENTRAL MINNESOTA HOME CARE, INC.

Table of content: YAEL BENPORAT L.AC., DAOM, MPH (NPI 1326316027)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942440441 NPI number — CENTRAL MINNESOTA HOME CARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTRAL MINNESOTA HOME CARE, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1942440441
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/24/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
22413 STATE HIGHWAY 6
Provider Second Line Business Mailing Address:
200
Provider Business Mailing Address City Name:
DEERWOOD
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
56444-6245
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
218-546-5000
Provider Business Mailing Address Fax Number:
218-546-5033

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
22413 STATE HIGHWAY 6
Provider Second Line Business Practice Location Address:
200
Provider Business Practice Location Address City Name:
DEERWOOD
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56444-6245
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
218-546-5000
Provider Business Practice Location Address Fax Number:
218-546-5033
Provider Enumeration Date:
02/24/2009

Additional Information

Authorized Official

Authorized Official Last Name:
PETERSON
Authorized Official First Name:
VICTORIA
Authorized Official Middle Name:
LIVINGSTON
Authorized Official Title or Position:
ADMINISTRATOR/OWNER
Authorized Official Telephone Number:
218-546-5000

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X , with the licence number:  342906 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: 342906 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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