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General NPI Number Information
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NPI Number | 1821189275
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Entity Type | Organization
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Legal Business Name | LYNGBLOMSTEN SERVICES, INC
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1415 ALMOND AVE
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City | SAINT PAUL
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State | MN
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Zip | 55108-2507
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Country | US
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Telephone | 651-646-2941
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Fax | 651-646-8360
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Provider Business Mailing Address
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Address Line | 1415 ALMOND AVE
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City | SAINT PAUL
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State | MN
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Zip | 55108-2507
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Country | US
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Telephone | 651-646-2941
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Fax | 651-646-8360
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Authorized Official
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Title or Position | ASSISTANT ADMINSTRATOR
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Name | JANET MARIE BYRNES
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Credential | BA; MA;
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Telephone | 651-646-2941
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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 | HFID-03381
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License Number State | MN
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