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General NPI Number Information
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NPI Number | 1700204450
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Entity Type | Organization
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Legal Business Name | GVP SENIOR CARE CENTER, INC.
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Dates
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Enumeration Date | 03/31/2014
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Last Update Date | 03/31/2014
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Provider Practice Location Address
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Address Line | 1600 WHITE BEAR AVE N
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City | SAINT PAUL
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State | MN
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Zip | 55106-1608
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Country | US
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Telephone | 651-444-8183
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Fax | 651-444-8182
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Provider Business Mailing Address
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Address Line | 1600 WHITE BEAR AVE N
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City | SAINT PAUL
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State | MN
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Zip | 55106-1608
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Country | US
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Telephone | 651-444-8183
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Fax | 651-444-8182
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. TOUNEY T XIONG
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Credential |
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Telephone | 651-444-8183
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | 1066212-1-ADC
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License Number State | MN
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