Organization
IMANI HOSPITALITY HOMECARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DONTRELL VALERIE THORNTON (OWNER/ADMINSTRATOR)
(651) 917-9015
Entity
Organization
Contact information
Practice address
501 DALE ST N, SAINT PAUL, MN 55103-1914
(651) 917-9015
(651) 645-9937
Mailing address
501 DALE ST N, SAINT PAUL, MN 55103-1914
(651) 917-9015
(651) 645-9937
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
A280407700
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A280407700
PERSONAL CARE PROVIDER ORGANIZATION
MN
Enumeration date
09/30/2009
Last updated
09/30/2009
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