Organization
MINNESOTA HAVEN HOMES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS SIA JAMILA SOGBEH RN (REGISTERED NURSE)
(612) 245-1658
Entity
Organization
Contact information
Practice address
8227 12 AVENUE S., BLOOMINGTON, MN 55423
(612) 245-1658
(651) 207-6841
Mailing address
8227 12 AVENUE S., BLOOMINGTON, MN 55423
(612) 245-1658
(651) 207-6841
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
R166070-8
MN
Other
Enumeration date
05/03/2007
Last updated
08/22/2020
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