Provider Demographics
NPI:1124848593
Name:AMERICARE TWIN CITIES NORTH LLC
Entity type:Organization
Organization Name:AMERICARE TWIN CITIES NORTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:MATHEWSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-283-8998
Mailing Address - Street 1:214 144TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MN
Mailing Address - Zip Code:55304-6264
Mailing Address - Country:US
Mailing Address - Phone:763-283-8998
Mailing Address - Fax:
Practice Address - Street 1:214 144TH AVE NW
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MN
Practice Address - Zip Code:55304-6264
Practice Address - Country:US
Practice Address - Phone:763-283-8998
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-11
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care