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General NPI Number Information
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NPI Number | 1063665826
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Entity Type | Organization
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Legal Business Name | S.E.A. SENIOR DAY CARE, LLC
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Dates
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Enumeration Date | 10/24/2008
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Last Update Date | 05/13/2021
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Provider Practice Location Address
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Address Line | 2365 LOUISIANA AVE N
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City | GOLDEN VALLEY
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State | MN
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Zip | 55427-3632
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Country | US
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Telephone | 612-234-7799
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Fax | 888-611-4665
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Provider Business Mailing Address
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Address Line | PO BOX 7604
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City | MINNEAPOLIS
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State | MN
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Zip | 55407
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Country | US
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Telephone | 612-234-7799
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Fax | 888-611-4665
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Authorized Official
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Title or Position | OFFICER
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Name | TRUONG NGUYEN
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Credential |
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Telephone | 612-234-7799
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | MN
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