Provider Demographics
NPI:1952873630
Name:MELKEZEDEK CARE LLC
Entity Type:Organization
Organization Name:MELKEZEDEK CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MELCHIZEDEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-269-9313
Mailing Address - Street 1:8525 N EDINBROOK CROSSING SUITE 204
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55443
Mailing Address - Country:US
Mailing Address - Phone:763-269-9313
Mailing Address - Fax:763-432-3049
Practice Address - Street 1:8525 N EDINBROOK CROSSING SUITE 204
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55443
Practice Address - Country:US
Practice Address - Phone:763-269-9313
Practice Address - Fax:763-432-3049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-19
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty
No251E00000XAgenciesHome HealthGroup - Single Specialty