Organization
LAO SENIOR HEALTHY LIFE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAENG DOUA KUE (CENTER DIRECTOR)
(612) 227-1691
Entity
Organization
Contact information
Practice address
1501 W BROADWAY AVE, MINNEAPOLIS, MN 55411-2473
(612) 227-1691
(612) 529-4570
Mailing address
7250 CAMDEN AVE N, BROOKLYN CENTER, MN 55430-1229
(612) 227-1691
(612) 529-4570
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
1048831-4-ADC
MN
Other
Enumeration date
11/27/2012
Last updated
11/27/2012
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