MEDICARE: CHINESE SOCIAL SERVICE CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	353124	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558659805
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHINESE SOCIAL SERVICE CENTER

Provider Business Mailing Address
First Line	:	4111 CENTRAL AVE NE
Second Line	:	SUITE 200A, SOUTH BUILDING
City	:	COLUMBIA HEIGHTS
State	:	MN
Zip	:	55421-2953
Country	:	US
Telephone Number	:	612-529-2602
Fax Number	:	612-465-2733

Provider Business Practice Location Address
First Line	:	4111 CENTRAL AVE NE
Second Line	:	SUITE 200A, SOUTH BUILDING
City	:	COLUMBIA HEIGHTS
State	:	MN
Zip	:	55421-2953
Country	:	US
Telephone Number	:	612-529-2602
Fax Number	:	612-465-2733

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MS. YI LI YOU
Credential	:	LSW
Telephone Number	:	612-529-2602

Provider Enumeration Date	:	07/20/2011
Last Update Date	:	05/29/2015

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Directions to “CHINESE SOCIAL SERVICE CENTER ” Practice Location

Language	Start Address	Practice Location

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