Healthcare Provider Details

I. General information

NPI: 1003771494
Provider Name (Legal Business Name): J&S GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6319 CAMBRIDGE ST
ST LOUIS PARK MN
55416
US

IV. Provider business mailing address

6319 CAMBRIDGE ST
ST LOUIS PARK MN
55416
US

V. Phone/Fax

Practice location:
  • Phone: 612-423-6420
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: SENGSADETH MEHTA
Title or Position: OWNER/ PRESIDENT
Credential:
Phone: 612-423-6420