Provider Demographics
NPI:1508197773
Name:PARKINSONS SPECIALTY CARE
Entity Type:Organization
Organization Name:PARKINSONS SPECIALTY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMILTON-DOONER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-550-1774
Mailing Address - Street 1:10405 6TH AVE N STE 130
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55441-6381
Mailing Address - Country:US
Mailing Address - Phone:763-550-1774
Mailing Address - Fax:
Practice Address - Street 1:6804 DOVRE DR
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55436-1715
Practice Address - Country:US
Practice Address - Phone:952-988-9900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-27
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN345503310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility