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General NPI Number Information
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NPI Number | 1003073487
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Entity Type | Organization
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Legal Business Name | HARMONY HOMES OF MINNESOTA LLC
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Dates
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Enumeration Date | 05/22/2008
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Last Update Date | 05/22/2008
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Provider Practice Location Address
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Address Line | 7935 DRAKE RD
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City | WOODBURY
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State | MN
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Zip | 55125-1446
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Country | US
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Telephone | 612-414-8329
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Fax | 651-714-2637
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Provider Business Mailing Address
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Address Line | 7935 DRAKE RD
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City | WOODBURY
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State | MN
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Zip | 55125-1446
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. ELIZABETH ANN HANSON
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Credential | JD
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Telephone | 612-414-8329
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number | 1016299
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License Number State | MN
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