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General NPI Number Information
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NPI Number | 1508042540
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Entity Type | Organization
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Legal Business Name | WINDELS HEALTH SERVICES
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Dates
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Enumeration Date | 01/20/2008
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Last Update Date | 09/16/2008
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Provider Practice Location Address
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Address Line | 12401 OAK PARK BLVD. APT. #310
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City | BLAINE
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State | MN
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Zip | 55449
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Country | US
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Telephone | 651-263-3854
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Fax |
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Provider Business Mailing Address
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Address Line | 1896 124TH LANE NE
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City | BLAINE
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State | MN
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Zip | 55449
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Country | US
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Telephone | 651-263-3854
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Fax |
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | MR. DELAH M. AZUMAH
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Credential |
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Telephone | 651-263-3854
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 005105000
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 338346
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License Number State | MN
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