NPI | 1225676067 |
---|---|
Entity Type | Organization |
Authorized Contact | LILIANA KIGONYA Medical Director 651-300-4355 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
Additional Taxonomies | 251B00000X Case Management |
251G00000X Hospice Care, Community Based | |
253Z00000X In Home Supportive Care | |
261Q00000X Clinic/Center | |
261QM1000X Clinic/Center Migrant Health | |
261QM1102X Clinic/Center Military Outpatient Operational (Transportable) Component | |
261QM2800X Clinic/Center Methadone | |
261QP2400X Clinic/Center Prison Health | |
261QU0200X Clinic/Center Urgent Care | |
310400000X Assisted Living Facility | |
314000000X Skilled Nursing Facility | |
320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | |
320800000X Community Based Residential Treatment Facility, Mental Illness | |
Enumeration Date | 2019-12-11 |
Last Update Date | 2019-12-11 |