Provider Demographics
NPI:1598991440
Name:TWINS CARE NURSING SERVICE PCA, INC
Entity Type:Organization
Organization Name:TWINS CARE NURSING SERVICE PCA, INC
Other - Org Name:TWINS CARE NURSING SERVICE, INC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHERRI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-423-1204
Mailing Address - Street 1:14708 ENDICOTT WAY
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55124-6491
Mailing Address - Country:US
Mailing Address - Phone:952-423-1204
Mailing Address - Fax:952-423-4113
Practice Address - Street 1:14708 ENDICOTT WAY
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124-6491
Practice Address - Country:US
Practice Address - Phone:952-423-1204
Practice Address - Fax:952-423-4113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-05
Last Update Date:2009-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNM051467100310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNM051467100Medicaid