Provider Demographics
NPI:1811872179
Name:3D INNOVATIVE CARES LLC
Entity type:Organization
Organization Name:3D INNOVATIVE CARES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:ABISOYE
Authorized Official - Middle Name:
Authorized Official - Last Name:AKINTAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-745-6387
Mailing Address - Street 1:8824 138TH ST W
Mailing Address - Street 2:
Mailing Address - City:SAVAGE
Mailing Address - State:MN
Mailing Address - Zip Code:55378-3130
Mailing Address - Country:US
Mailing Address - Phone:310-745-6387
Mailing Address - Fax:
Practice Address - Street 1:11724 BITTERSWEET ST NW
Practice Address - Street 2:
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55433-2914
Practice Address - Country:US
Practice Address - Phone:310-745-6387
Practice Address - Fax:763-201-9026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-07
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility