Healthcare Provider Details

I. General information

NPI: 1457681421
Provider Name (Legal Business Name): ASIAN ADULT DAY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2010
Last Update Date: 11/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1410 ENERGY PARK DR STE 1
SAINT PAUL MN
55108-5249
US

IV. Provider business mailing address

1410 ENERGY PARK DR STE 1
SAINT PAUL MN
55108-5249
US

V. Phone/Fax

Practice location:
  • Phone: 651-260-6048
  • Fax: 651-797-3868
Mailing address:
  • Phone: 651-260-6048
  • Fax: 651-797-3868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: PAFOUA VANG
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 651-260-6048