Organization
VAIMAR SUITES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIN S MUMBUWA (ADMINISTRATOR/OWNER)
(952) 221-7318
Entity
Organization
Contact information
Practice address
7900 DOUGLAS DR N, BROOKLYN PARK, MN 55443-2046
(763) 432-3008
Mailing address
4845 FERNCROFT DR, EXCELSIOR, MN 55331-8750
(952) 221-7318
(651) 521-4223
Taxonomy
Speciality
Code
Description
License number
State
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
—
—
Other
Enumeration date
05/26/2020
Last updated
05/26/2020
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