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General NPI Number Information
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NPI Number | 1063798460
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Entity Type | Organization
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Legal Business Name | STUARTCO
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Dates
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Enumeration Date | 10/30/2011
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Last Update Date | 10/30/2011
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Provider Practice Location Address
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Address Line | 2235 ROCKWOOD AVE
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City | SAINT PAUL
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State | MN
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Zip | 55116-3175
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Country | US
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Telephone | 651-698-3954
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Fax | 651-698-4013
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Provider Business Mailing Address
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Address Line | 1000 W 80TH ST
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City | MINNEAPOLIS
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State | MN
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Zip | 55420-1009
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Country | US
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Telephone | 952-948-9500
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Fax | 952-948-9570
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Authorized Official
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Title or Position | CEO
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Name | LISA MOE
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Credential |
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Telephone | 952-948-9500
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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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