PHOUVIENG SIVILAY

EDEN PRAIRIE, MN
NPI1245012715
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy310400000X Assisted Living Facility
(Licence: MN  39902)
Enumeration Date2023-10-18
Last Update Date2023-10-18
Business Address
PHOUVIENG SIVILAY
10452 SPYGLASS DR
EDEN PRAIRIE, MN 55347-4656
Phone number: 612-508-8743
Mailing Address
PHOUVIENG SIVILAY
10428 SHELTER GRV
EDEN PRAIRIE, MN 55347-4855
Phone number: 612-508-8743