Provider Demographics
NPI:1093819708
Name:CONNECTCARE
Entity Type:Organization
Organization Name:CONNECTCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DEEANN
Authorized Official - Middle Name:JOLENE
Authorized Official - Last Name:DICKE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:320-234-4611
Mailing Address - Street 1:710 PARK ISLAND DR SW
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:MN
Mailing Address - Zip Code:55350-2046
Mailing Address - Country:US
Mailing Address - Phone:320-234-5031
Mailing Address - Fax:320-234-5032
Practice Address - Street 1:710 PARK ISLAND DR SW
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:MN
Practice Address - Zip Code:55350-2046
Practice Address - Country:US
Practice Address - Phone:320-234-5031
Practice Address - Fax:320-234-5032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN333224251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN24-1572Medicare ID - Type UnspecifiedHOSPICE