Organization
WABO ALF LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHRISTINE KENGNE (OWNER)
(612) 919-7002
Entity
Organization
Contact information
Practice address
8371 5TH STREET NE, SPRING LAKE PARK, MN 55432
(612) 919-7002
(612) 329-0183
Mailing address
8371 5TH STREET NE, SPRING LAKE PARK, MN 55432
(612) 919-7002
(612) 329-0183
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
08/11/2023
Last updated
10/05/2023
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