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General NPI Number Information
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NPI Number | 1184928475
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Entity Type | Organization
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Legal Business Name | MARIAS HOME INC
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Dates
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Enumeration Date | 12/31/2010
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Last Update Date | 12/31/2010
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Provider Practice Location Address
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Address Line | 8000 WINNETKA HEIGHTS DR
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City | GOLDEN VALLEY
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State | MN
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Zip | 55427-3458
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Country | US
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Telephone | 763-232-3585
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Fax | 763-546-9334
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Provider Business Mailing Address
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Address Line | 8000 WINNETKA HEIGHTS DR
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City | GOLDEN VALLEY
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State | MN
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Zip | 55427-3458
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Country | US
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Telephone | 763-232-3585
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Fax | 763-546-9334
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Authorized Official
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Title or Position | OWNER
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Name | VLADIMIR PAVLOVICH SAYKO
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Credential |
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Telephone | 763-232-3585
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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 |
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