Provider Demographics
NPI:1356587851
Name:CAREFOCUS HEALTH INC
Entity type:Organization
Organization Name:CAREFOCUS HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADEWALE
Authorized Official - Middle Name:OLADOTUN
Authorized Official - Last Name:KOLEOSHO
Authorized Official - Suffix:
Authorized Official - Credentials:BBA
Authorized Official - Phone:651-756-7932
Mailing Address - Street 1:2429 UNIVERSITY AVENUE W # 200A
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55114-1541
Mailing Address - Country:US
Mailing Address - Phone:651-756-7932
Mailing Address - Fax:651-200-4853
Practice Address - Street 1:2429 UNIVERSITY AVE W # 200A
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55114-1541
Practice Address - Country:US
Practice Address - Phone:651-756-7932
Practice Address - Fax:651-200-4853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-05
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNPENDING251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1356587851Medicaid