Organization
PRIMER SUPPORTIVE NETWORK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY NGOCHO NASILAI (CEO)
(651) 278-9352
Entity
Organization
Contact information
Practice address
7597 UPPER 24TH ST N, OAKDALE, MN 55128-5025
(651) 278-9352
Mailing address
7597 UPPER 24TH ST N, OAKDALE, MN 55128-5025
(651) 278-9352
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
342000000X
Transportation Network Company
—
—
Other
Enumeration date
02/21/2025
Last updated
02/21/2025
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