Organization
SENIOR HOME LIVING INC
Active
Other names
Maplewood Home Care
Organization subpart
No
Provider details
NPI number
Authorized official
GAOLEE CRYSTIE YANG (OWNER)
(952) 456-6561
Entity
Organization
Contact information
Practice address
1736 COPE AVE E STE 2, MAPLEWOOD, MN 55109-2661
(952) 456-6561
(952) 456-6563
Mailing address
1736 COPE AVE E STE 2, MAPLEWOOD, MN 55109-2661
(952) 456-6561
(952) 456-6563
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
337545
MN
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A721135000
—
MN
Enumeration date
10/09/2007
Last updated
05/08/2023
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