Organization
ELLENY FAMILY ADULT CARE CORPORATION
Active
Organization
ELLENY FAMILY ADULT CARE CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TEDLA A BELAYNEH (OWNER/AUTHORIZED AGENT)
(612) 999-0660
Entity
Organization
Contact information
Practice address
13626 GOSSAMER WAY, APPLE VALLEY, MN 55124-7875
(612) 999-0660
Mailing address
13626 GOSSAMER WAY, APPLE VALLEY, MN 55124-7875
(612) 999-0660
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
—
—
Other
Enumeration date
02/08/2022
Last updated
02/08/2022
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