Provider Demographics
NPI:1922364983
Name:METROPOLITAN CARE INC.
Entity Type:Organization
Organization Name:METROPOLITAN CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TIBESSO
Authorized Official - Middle Name:MIDHASSA
Authorized Official - Last Name:DAYASSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-425-0228
Mailing Address - Street 1:9613 EVERGREEN AVE N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55443-1567
Mailing Address - Country:US
Mailing Address - Phone:763-425-0228
Mailing Address - Fax:
Practice Address - Street 1:9613 EVERGREEN AVE N
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55443-1567
Practice Address - Country:US
Practice Address - Phone:763-425-0228
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-04
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN357257251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health