Healthcare Provider Details

I. General information

NPI: 1760909006
Provider Name (Legal Business Name): AMATUS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6266 DOUGLAS CT N
CHAMPLIN MN
55316-3572
US

IV. Provider business mailing address

6266 DOUGLAS CT N
CHAMPLIN MN
55316-3572
US

V. Phone/Fax

Practice location:
  • Phone: 763-200-5406
  • Fax: 763-200-5407
Mailing address:
  • Phone: 763-200-5406
  • Fax: 763-200-5407

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: CHOUA YANG
Title or Position: PRESIDENT
Credential:
Phone: 763-200-5406