Provider Demographics
NPI:1801658679
Name:NEDKACARE LLC
Entity type:Organization
Organization Name:NEDKACARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FELISTHER
Authorized Official - Middle Name:KEMUNTO
Authorized Official - Last Name:ACHOCHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-390-3839
Mailing Address - Street 1:4856 FLAG AVE N
Mailing Address - Street 2:
Mailing Address - City:NEW HOPE
Mailing Address - State:MN
Mailing Address - Zip Code:55428-4441
Mailing Address - Country:US
Mailing Address - Phone:612-390-3839
Mailing Address - Fax:
Practice Address - Street 1:4856 FLAG AVE N
Practice Address - Street 2:
Practice Address - City:NEW HOPE
Practice Address - State:MN
Practice Address - Zip Code:55428-4441
Practice Address - Country:US
Practice Address - Phone:612-390-3839
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-26
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility