Provider Demographics
NPI:1225208044
Name:HMONG MINNESOTA SENIOR CENTER
Entity Type:Organization
Organization Name:HMONG MINNESOTA SENIOR CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MANG
Authorized Official - Middle Name:
Authorized Official - Last Name:CHU-YANG-HEU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-216-2601
Mailing Address - Street 1:1730 GERVAIS AVE
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55109-2134
Mailing Address - Country:US
Mailing Address - Phone:651-770-0327
Mailing Address - Fax:
Practice Address - Street 1:1730 GERVAIS AVE
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-2134
Practice Address - Country:US
Practice Address - Phone:651-770-0327
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-07
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1049124261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care