Healthcare Provider Details

I. General information

NPI: 1144190323
Provider Name (Legal Business Name): OUR NEW HOME ELDER DAY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2025
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 5TH AVE S STE C
SOUTH SAINT PAUL MN
55075-3457
US

IV. Provider business mailing address

1515 5TH AVE S STE C
SOUTH SAINT PAUL MN
55075-3457
US

V. Phone/Fax

Practice location:
  • Phone: 651-269-3147
  • Fax:
Mailing address:
  • Phone: 651-269-3147
  • Fax:

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: MISS LIA PATRICIA DE LA TORRE
Title or Position: ADMINISTRATOR / OFFICER
Credential:
Phone: 651-269-3147