Provider Demographics
NPI:1174974786
Name:CARE PHYSICAL THRAPY, LLC
Entity type:Organization
Organization Name:CARE PHYSICAL THRAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HASSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-710-5056
Mailing Address - Street 1:8401 73RD AVE N
Mailing Address - Street 2:54
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55428-1505
Mailing Address - Country:US
Mailing Address - Phone:763-710-5056
Mailing Address - Fax:763-432-0493
Practice Address - Street 1:8401 73RD AVE N
Practice Address - Street 2:54
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55428-1505
Practice Address - Country:US
Practice Address - Phone:763-710-5056
Practice Address - Fax:763-432-0493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-24
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy