Organization
SENIOR HOME LIVING INC
Active
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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