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Organization
CHIMNEY PINES LLC
Active
Organization
CHIMNEY PINES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHOUVIENG SIVILAY PS (DIRECTOR/MANAGER)
(612) 508-8743
Entity
Organization
Contact information
Practice address
10452 SPYGLASS DR, EDEN PRAIRIE, MN 55347-4656
(612) 508-8743
Mailing address
10428 SHELTER GRV, EDEN PRAIRIE, MN 55347-4855
(612) 508-8743
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
12/11/2023
Last updated
12/11/2023
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