Organization
COMMUNITY HEALTHCARE SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLORIA IGWILOHI AGBATOR CO-OWNER (MANAGER)
(612) 636-3286
Entity
Organization
Contact information
Practice address
14249 HAYES RD, APPLE VALLEY, MN 55124-6738
(952) 891-8038
(952) 891-8038
Mailing address
14249 HAYES RD, APPLE VALLEY, MN 55124-6738
(952) 891-8038
(952) 891-8038
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
356758
MN
Other
Enumeration date
04/26/2012
Last updated
04/26/2012
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