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General NPI Number Information
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NPI Number | 1023173606
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Entity Type | Organization
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Legal Business Name | GIVING BACK HEALTH SERVICES INC
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Dates
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Enumeration Date | 12/26/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2363 ELDRIDGE AVE E
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City | NORTH SAINT PAUL
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State | MN
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Zip | 55109-4087
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Country | US
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Telephone | 651-214-8344
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Fax |
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Provider Business Mailing Address
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Address Line | 2357 ELDRIDGE AVE E
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City | NORTH SAINT PAUL
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State | MN
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Zip | 55109-4087
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Country | US
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Telephone | 651-214-8344
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. JAMES MICHEAL HAU
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Credential |
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Telephone | 651-214-8344
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | 10280831AFC
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License Number State | MN
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