Provider Demographics
NPI:1558127464
Name:TWIN CITIES RECUPERATIVE CARE
Entity Type:Organization
Organization Name:TWIN CITIES RECUPERATIVE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HANAS
Authorized Official - Middle Name:
Authorized Official - Last Name:KUMBI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-450-2856
Mailing Address - Street 1:1571 ROBERT ST S APT 346
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55118-4415
Mailing Address - Country:US
Mailing Address - Phone:612-450-2856
Mailing Address - Fax:
Practice Address - Street 1:1571 ROBERT ST S APT 346
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55118-4415
Practice Address - Country:US
Practice Address - Phone:612-450-2856
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care