Organization
MINNETONKA ASSISTED LIVING AND HOSPICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SOMACHANARY KRISTIE KUOCH CAREGIVER (OWNER)
(952) 405-6960
Entity
Organization
Contact information
Practice address
14667 LAKE STREET EXTENSION, MINNETONKA, MN 55345
(952) 405-6960
Mailing address
14667 LAKE STREET EXT, MINNETONKA, MN 55345-2926
(952) 405-6960
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
383702
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
82121568
—
MN
Enumeration date
09/26/2017
Last updated
07/21/2022
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