Provider Demographics
NPI:1235388810
Name:DISCOVERY HOME CARE INC.
Entity Type:Organization
Organization Name:DISCOVERY HOME CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WYCLIFFE
Authorized Official - Middle Name:
Authorized Official - Last Name:MOKAYA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:612-590-2733
Mailing Address - Street 1:8363 W 149TH ST
Mailing Address - Street 2:
Mailing Address - City:SAVAGE
Mailing Address - State:MN
Mailing Address - Zip Code:55378-4714
Mailing Address - Country:US
Mailing Address - Phone:952-888-0003
Mailing Address - Fax:952-888-1176
Practice Address - Street 1:8363 W 149TH ST
Practice Address - Street 2:
Practice Address - City:SAVAGE
Practice Address - State:MN
Practice Address - Zip Code:55378-4714
Practice Address - Country:US
Practice Address - Phone:952-888-0003
Practice Address - Fax:952-888-1176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-18
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN340259251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health