Healthcare Provider Details

I. General information

NPI: 1568120129
Provider Name (Legal Business Name): INDEPENDENT LIVING PLACEMENT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2021
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 6TH ST E STE 400A
SAINT PAUL MN
55101-2073
US

IV. Provider business mailing address

235 6TH ST E STE 400A
SAINT PAUL MN
55101-2073
US

V. Phone/Fax

Practice location:
  • Phone: 651-428-4811
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DAYANA VALMYR
Title or Position: OWNER
Credential:
Phone: 651-428-4811