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Organization

OUR LADY OF PEACE

Active
Other names
Highland Block Nurse Program
Organization subpart
No

Provider details

NPI number
Authorized official
JOSEPH STANISLAV (CEO/PRESIDENT)
(651) 789-5049
Entity
Organization

Contact information

Practice address
2076 SAINT ANTHONY AVE, SAINT PAUL, MN 55104-4543
(651) 696-8425
Mailing address
2076 SAINT ANTHONY AVE, SAINT PAUL, MN 55104-4543

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
253Z00000X
In Home Supportive Care Agency
Primary
347C00000X
Private Vehicle
385H00000X
Respite Care

Other

Enumeration date
01/31/2017
Last updated
06/08/2017
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