Provider Demographics
NPI:1326265455
Name:HMONG ELDERS CENTER, INC.
Entity Type:Organization
Organization Name:HMONG ELDERS CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:TED
Authorized Official - Middle Name:
Authorized Official - Last Name:XIONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-283-8480
Mailing Address - Street 1:430 DALE ST N
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55103-2255
Mailing Address - Country:US
Mailing Address - Phone:651-224-2774
Mailing Address - Fax:651-224-1882
Practice Address - Street 1:430 DALE ST N
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55103-2255
Practice Address - Country:US
Practice Address - Phone:651-224-2774
Practice Address - Fax:651-224-1882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN10425351ADC385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN4980728OtherMEDICA DUAL SOLUTIONS
MN126318OtherHEALTHPARTNERS
MN183911OtherUCARE MN