Provider Demographics
NPI:1558745901
Name:ELDER CARE DAY SERVICES, LLC
Entity Type:Organization
Organization Name:ELDER CARE DAY SERVICES, LLC
Other - Org Name:ELDER CARE DAY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER / CENTER COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:SOUK
Authorized Official - Middle Name:
Authorized Official - Last Name:HER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-734-3913
Mailing Address - Street 1:1774 COPE AVE.
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55109
Mailing Address - Country:US
Mailing Address - Phone:651-734-3913
Mailing Address - Fax:651-440-9118
Practice Address - Street 1:1774 COPE AVE.
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109
Practice Address - Country:US
Practice Address - Phone:651-734-3913
Practice Address - Fax:651-440-9118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-16
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1076075261QA0600X, 343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)