=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225327802
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GIVING HOPE HOMES, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/04/2011
-----------------------------------------------------
Last Update Date | 04/04/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1919 IGLEHART AVE
-----------------------------------------------------
City | SAINT PAUL
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55104-5140
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 612-481-2146
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1919 IGLEHART AVE
-----------------------------------------------------
City | SAINT PAUL
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55104-5140
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 612-481-2146
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | PANOU XIONG
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 612-481-2146
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 311ZA0620X
-----------------------------------------------------
Taxonomy Name | Adult Care Home Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | MN
-----------------------------------------------------