Provider Demographics
NPI:1467502070
Name:CAREFOCUS CORPORATION
Entity type:Organization
Organization Name:CAREFOCUS CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NURSING
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEAD
Authorized Official - Suffix:
Authorized Official - Credentials:DIRECTOR OF NURSING
Authorized Official - Phone:651-925-5598
Mailing Address - Street 1:2429 UNIVERSITY AVENUE WEST
Mailing Address - Street 2:
Mailing Address - City:ST. PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55114
Mailing Address - Country:US
Mailing Address - Phone:651-925-5598
Mailing Address - Fax:651-925-5599
Practice Address - Street 1:2429 UNIVERSITY AVENUE WEST
Practice Address - Street 2:
Practice Address - City:ST. PAUL
Practice Address - State:MN
Practice Address - Zip Code:55114
Practice Address - Country:US
Practice Address - Phone:952-544-6223
Practice Address - Fax:952-544-6271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN876405100251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN3D30CAOtherBLUE CROSS BLUE SHIELD
MN000821001OtherMETRO POLITAN HEALTH PLAN
150333OtherUCARE
MN876405100Medicaid
MN5900207OtherMEDICA
150333OtherUCARE
MN=========OtherUNITED HEALTH CARE
MN=========OtherALPHA REVIEW CORP
MN5900207OtherMEDICA
MNV=========-69754OtherHEALTH PARTNERS
MNV=========-69754OtherHEALTH PARTNERS