| NPI | 1811544166 |
|---|---|
| Doing Business As | PHC MAPLE GROVE |
| Entity Type | Organization |
| Authorized Contact | FAISALE BOUKARI President 763-444-1361 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251J00000X Nursing Care |
| Additional Taxonomies | 251E00000X Home Health |
| 253Z00000X In Home Supportive Care | |
| Enumeration Date | 2019-08-21 |
| Last Update Date | 2019-08-21 |