Organization
ST. JUDE HOME HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOROTHY MING'ATE (ASSISTED LIVING DIRECTOR)
(612) 245-5167
Entity
Organization
Contact information
Practice address
4506 IMPATIENS AVE N, BROOKLYN PARK, MN 55443-1552
(612) 245-5167
(952) 314-9282
Mailing address
6160 SUMMIT DR N STE 320, MINNEAPOLIS, MN 55430-2181
(612) 460-0018
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
310400000X
Assisted Living Facility
—
—
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
—
—
Other
Enumeration date
07/17/2023
Last updated
07/17/2023
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