Healthcare Provider Details

I. General information

NPI: 1861359820
Provider Name (Legal Business Name): A VISION OF HOPE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2026
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2065 CARNELIAN LN
EAGAN MN
55122-2867
US

IV. Provider business mailing address

2065 CARNELIAN LN
EAGAN MN
55122-2867
US

V. Phone/Fax

Practice location:
  • Phone: 651-428-9045
  • Fax:
Mailing address:
  • Phone: 651-428-9045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: PAMELA K KING
Title or Position: ADMINISTRATOR
Credential:
Phone: 651-428-9045