Provider Demographics
NPI:1326222811
Name:SENIOR CLASS HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:SENIOR CLASS HOME HEALTH CARE LLC
Other - Org Name:SENIOR CLASS CAREN DBA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SANDELIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-839-1895
Mailing Address - Street 1:PO BOX 852
Mailing Address - Street 2:
Mailing Address - City:PEQUOT LAKES
Mailing Address - State:MN
Mailing Address - Zip Code:56472
Mailing Address - Country:US
Mailing Address - Phone:218-839-1895
Mailing Address - Fax:
Practice Address - Street 1:30849 1ST ST
Practice Address - Street 2:
Practice Address - City:PEQUOT LAKES
Practice Address - State:MN
Practice Address - Zip Code:56472
Practice Address - Country:US
Practice Address - Phone:218-568-1098
Practice Address - Fax:218-568-1097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-20
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN335989251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health