Minnesota Life Care Services

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

335308 Issued in MN

Legal business name

MINNESOTA LIFE CARE SERVICES

Practice address

5280 Annapolis LN N
Plymouth, MN 55446-3614

Phone

(763) 577-1501

Fax

(763) 577-1502

NPI assigned

Mar 28, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

John Tarley

Title

President

Phone

(763) 560-8995

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669591954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7710 BROOKLYN BLVD",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554432979",
            "telephone_number": "763-560-9643",
            "fax_number": "763-560-9720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5280 ANNAPOLIS LN N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554463614",
            "telephone_number": "763-577-1501",
            "fax_number": "763-577-1502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINNESOTA LIFE CARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TARLEY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "763-560-8995"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MN",
            "license": "335308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Plymouth, MN
• Providers in Plymouth, MN by specialty
• Home Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.