Individual
MS. ADELLA JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1235 LAKE ST, NORTH MANKATO, MN 56003-2030
(507) 469-8527
Mailing address
1235 LAKE ST, NORTH MANKATO, MN 56003-2030
(507) 469-8527
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
208344-1-AFC
MN
Other
Enumeration date
04/29/2014
Last updated
04/29/2014
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