Provider Demographics
NPI:1184824534
Name:THREE K'S CARE SERVICES, INC.
Entity type:Organization
Organization Name:THREE K'S CARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN/ CEO
Authorized Official - Prefix:
Authorized Official - First Name:QUEENA
Authorized Official - Middle Name:KOTU
Authorized Official - Last Name:SLOAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:763-913-0325
Mailing Address - Street 1:7600 BASS LAKE RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NEW HOPE
Mailing Address - State:MN
Mailing Address - Zip Code:55428-3860
Mailing Address - Country:US
Mailing Address - Phone:763-544-3148
Mailing Address - Fax:763-544-3149
Practice Address - Street 1:7601 36TH AVE N
Practice Address - Street 2:
Practice Address - City:CRYSTAL
Practice Address - State:MN
Practice Address - Zip Code:55427-2014
Practice Address - Country:US
Practice Address - Phone:763-546-1117
Practice Address - Fax:763-546-1118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-24
Last Update Date:2008-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN340724310400000X
MN340738251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility