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Organization

IDA'S HOUSE L.L.C.

Active
Other names
Ida's House
Organization subpart
No

Provider details

NPI number
Authorized official
MR. LARRY DARNELL SCOTT (DIRECTOR/MANAGING AGENT)
(612) 327-0573
Entity
Organization

Contact information

Practice address
1014 IVY AVE E, SAINT PAUL, MN 55106-2082
(612) 327-0573
Mailing address
PO BOX 431403, BROOKLYN PARK, MN 55443-7432
(612) 327-0573

Taxonomy

Speciality
Code
Description
License number
State
174200000X
Meals Provider
177F00000X
Lodging Provider
251S00000X
Community/Behavioral Health Agency
253Z00000X
In Home Supportive Care Agency
310400000X
Assisted Living Facility
Primary
315P00000X
Intellectual Disabilities Intermediate Care Facility
343900000X
Non-emergency Medical Transport (VAN)

Other

Enumeration date
03/05/2025
Last updated
03/05/2025
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