Provider Demographics
NPI:1093461352
Name:EASTSIDE HOME HEALTH CARE CORPORATION
Entity Type:Organization
Organization Name:EASTSIDE HOME HEALTH CARE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TOU
Authorized Official - Middle Name:
Authorized Official - Last Name:XIONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-528-1500
Mailing Address - Street 1:1415 ARCADE ST STE C
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55106-1832
Mailing Address - Country:US
Mailing Address - Phone:651-528-1500
Mailing Address - Fax:651-776-5000
Practice Address - Street 1:1415 ARCADE ST STE C
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55106-1832
Practice Address - Country:US
Practice Address - Phone:651-528-1500
Practice Address - Fax:651-776-5000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-25
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care