Healthcare Provider Details

I. General information

NPI: 1326265455
Provider Name (Legal Business Name): HMONG ELDERS CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 07/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 DALE ST N
SAINT PAUL MN
55103-2255
US

IV. Provider business mailing address

430 DALE ST N
SAINT PAUL MN
55103-2255
US

V. Phone/Fax

Practice location:
  • Phone: 651-224-2774
  • Fax: 651-224-1882
Mailing address:
  • Phone: 651-224-2774
  • Fax: 651-224-1882

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number10425351ADC
License Number StateMN

VIII. Authorized Official

Name: TED XIONG
Title or Position: PRESIDENT, FOUNDER
Credential:
Phone: 651-283-8480