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CUSTOMCARE LLC. NPI 1922185677


NPI Information

NPI: 1922185677
Provider Name: CUSTOMCARE, LLC.
Classification: Custodial Care Facility - 311Z00000X
Entity Type: Organization
Address:
7801 E BUSH LAKE RD STE 100
MINNEAPOLIS, MN
ZIP 55439
Phone: (952) 914-0269
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CUSTOMCARE, LLC. is a custodial care facility in Minneapolis, MN. The provider is a facility providing care that serves to assist an individual in the activities of daily living, such as assistance in walking, getting in and out of bed, bathing, dressing, feeding, and using the toilet, preparation of special diets, and supervision of medication that usually can be self-administered. Custodial care essentially is personal care that does not require the continuing attention of trained medical or paramedical personnel. CUSTOMCARE, LLC. NPI is 1922185677. The provider is registered as an organization entity type.

The provider's business location address is:

7801 E BUSH LAKE RD STE 100
MINNEAPOLIS, MN
ZIP 55439-111
Phone: (952) 914-0269
Fax: (952) 960-5681

The provider's authorized official is Calvin Miller .
The authorized official title is Administrator and has the following contact phone number (952) 914-0269.

The enumeration date for this NPI number is 11/1/2006 and was last updated on 12/7/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1385H00000XRespite CareNo
2251E00000XHome HealthNo
3311Z00000XCustodial Care FacilityYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1081603500MEDICAIDMINNESOTA
2807970600MEDICAIDMINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.