Healthcare Provider Details

I. General information

NPI: 1922693209
Provider Name (Legal Business Name): HARMONY ADULT DAY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2021
Last Update Date: 03/08/2021
Certification Date: 03/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

475 ETNA ST STE 12
SAINT PAUL MN
55106-6000
US

IV. Provider business mailing address

475 ETNA ST STE 12
SAINT PAUL MN
55106-6000
US

V. Phone/Fax

Practice location:
  • Phone: 651-797-3640
  • Fax: 651-528-6242
Mailing address:
  • Phone: 651-797-3640
  • Fax: 651-528-6242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PANG YANG
Title or Position: PROGRAM MANAGER
Credential:
Phone: 651-354-8609