Provider Demographics
NPI:1093982324
Name:THE WORK CONNECTION
Entity Type:Organization
Organization Name:THE WORK CONNECTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PAYROLL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:RAITER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-251-7810
Mailing Address - Street 1:979 ARCADE ST
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55106-3229
Mailing Address - Country:US
Mailing Address - Phone:651-251-7810
Mailing Address - Fax:651-774-9690
Practice Address - Street 1:979 ARCADE ST
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55106-3229
Practice Address - Country:US
Practice Address - Phone:651-251-7810
Practice Address - Fax:651-774-9690
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-15
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN630033200OtherTHIRD PARTY WAVIER