Provider Demographics
NPI:1396204590
Name:TWIN CITY ADULT DAY SERVICES LLC
Entity Type:Organization
Organization Name:TWIN CITY ADULT DAY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAY
Authorized Official - Middle Name:NMN
Authorized Official - Last Name:SOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:651-398-1728
Mailing Address - Street 1:2231 11TH AVE E
Mailing Address - Street 2:
Mailing Address - City:NORTH ST PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55109-5158
Mailing Address - Country:US
Mailing Address - Phone:651-398-1728
Mailing Address - Fax:
Practice Address - Street 1:2231 11TH AVE E
Practice Address - Street 2:
Practice Address - City:NORTH ST PAUL
Practice Address - State:MN
Practice Address - Zip Code:55109-5158
Practice Address - Country:US
Practice Address - Phone:651-398-1728
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-18
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services