Provider Demographics
NPI:1164117602
Name:ZETA COMMUNITY CARE INC
Entity Type:Organization
Organization Name:ZETA COMMUNITY CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ZAKARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:NUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-210-6472
Mailing Address - Street 1:2380 WYCLIFF ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55114-1257
Mailing Address - Country:US
Mailing Address - Phone:651-210-6472
Mailing Address - Fax:
Practice Address - Street 1:2380 WYCLIFF ST
Practice Address - Street 2:SUITE 110
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55114-1257
Practice Address - Country:US
Practice Address - Phone:651-210-6472
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health