NPI 1811544166
Plateau Healthcare Maple Grove LLC
Practice location
- Address
- 9962 104th Ave N, Maple Grove, MN 55369-2941
- Phone
- (763) 444-1361
- Fax
- (763) 444-1358
- Mailing address
- 8848 Zealand Ave N STE B, Brooklyn Park, MN 55445-1891
Authorised official
- Name
- Faisale Boukari
- Title
- President
- Phone
- (763) 444-1361
Registered specialties (3)
Nursing Care Agency
Primary
Home Health Agency
In Home Supportive Care Agency
Registry record
- NPI
- 1811544166
- Entity type
- Organization
- NPI issued
- 21 Aug 2019
- Record last updated
- 21 Aug 2019
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.