Provider Demographics
NPI:1043825284
Name:CHARITY CARE INC PROFESSIONAL SERVICE CORPORATION
Entity Type:Organization
Organization Name:CHARITY CARE INC PROFESSIONAL SERVICE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHARITY
Authorized Official - Middle Name:NYAMISA
Authorized Official - Last Name:ONGERI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-273-6110
Mailing Address - Street 1:2816 92ND CRES N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55443-1743
Mailing Address - Country:US
Mailing Address - Phone:763-273-6110
Mailing Address - Fax:763-312-2278
Practice Address - Street 1:10909 BRITTANY DR N
Practice Address - Street 2:
Practice Address - City:CHAMPLIN
Practice Address - State:MN
Practice Address - Zip Code:55316-3838
Practice Address - Country:US
Practice Address - Phone:763-273-6110
Practice Address - Fax:763-312-2278
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHARITY CARE INC PROFESSIONAL SERVICE CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-09-14
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty