Provider Demographics
NPI:1700692688
Name:CARE CHEXX LLC
Entity type:Organization
Organization Name:CARE CHEXX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:A
Authorized Official - Last Name:LATTIMORE
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:763-221-3558
Mailing Address - Street 1:2552 TOURNAMENT PLAYERS CIR N
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:55449-5667
Mailing Address - Country:US
Mailing Address - Phone:763-221-3558
Mailing Address - Fax:763-205-5108
Practice Address - Street 1:2701 FREEWAY BLVD
Practice Address - Street 2:
Practice Address - City:BROOKLYN CENTER
Practice Address - State:MN
Practice Address - Zip Code:55430-1720
Practice Address - Country:US
Practice Address - Phone:763-549-5571
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-05
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care