Organization
5 STAR ADULT DAY CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL MICHAEL THAO (EXECUTIVE DIRECTOR)
(651) 788-7238
Entity
Organization
Contact information
Practice address
2966 WHITE BEAR AVE N, MAPLEWOOD, MN 55109-1318
(651) 788-7238
(651) 756-8553
Mailing address
2966 WHITE BEAR AVE N, MAPLEWOOD, MN 55109-1318
(651) 788-7238
(651) 756-8553
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A722602400
—
MN
Enumeration date
07/01/2021
Last updated
07/01/2021
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