DJM Pca Services LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

DJM PCA SERVICES LLC

Practice address

3517 34TH Ave S
Minneapolis, MN 55406-2732

Phone

(612) 889-1945

NPI assigned

Feb 20, 2017

Organization subpart

No

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

Authorized official

Name

Delores Jessica McClerin

Title

Owner

Phone

(612) 889-1945

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1487548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487548800000",
    "number": "1982143293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3517 34TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554062732",
            "telephone_number": "612-889-1945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3517 34TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554062732",
            "telephone_number": "612-889-1945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DJM PCA SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-20",
        "last_updated": "2017-02-20",
        "status": "A",
        "authorized_official_last_name": "MCCLERIN",
        "authorized_official_first_name": "DELORES",
        "authorized_official_middle_name": "JESSICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-889-1945"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• In Home Supportive Care Agency in Minneapolis, MN
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2017; 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.