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General NPI Number Information
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NPI Number | 1447741152
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Entity Type | Organization
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Legal Business Name | MODERN SISTER'S HOME HEALTHCARE, LLC
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Dates
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Enumeration Date | 05/29/2018
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 31533 FOREST BLVD
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City | STACY
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State | MN
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Zip | 55079-9238
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Country | US
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Telephone | 763-754-6732
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Fax | 763-754-6179
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Provider Business Mailing Address
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Address Line | 31533 FOREST BLVD
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City | STACY
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State | MN
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Zip | 55079-9238
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Country | US
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Telephone | 763-754-6732
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Fax | 763-754-6179
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Authorized Official
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Title or Position | OWNER
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Name | MARY YANG
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Credential | PHARM. D
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Telephone | 763-754-6732
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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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