Provider Demographics
NPI:1851150825
Name:MINNESOTA RECUPERATIVE CARE LLC
Entity Type:Organization
Organization Name:MINNESOTA RECUPERATIVE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUDHIR
Authorized Official - Middle Name:K
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:176-344-3211
Mailing Address - Street 1:1113 E FRANKLIN AVE STE 119
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-2982
Mailing Address - Country:US
Mailing Address - Phone:763-443-2112
Mailing Address - Fax:
Practice Address - Street 1:16600 40TH AVE N
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55446-2687
Practice Address - Country:US
Practice Address - Phone:763-443-2112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-13
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0800XAmbulatory Health Care FacilitiesClinic/CenterRecovery Care
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center