Provider Demographics
NPI:1437402591
Name:TWIN CITIES HOUSING WITH SERVICES, LLC.
Entity Type:Organization
Organization Name:TWIN CITIES HOUSING WITH SERVICES, LLC.
Other - Org Name:NONE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KORME
Authorized Official - Middle Name:UKA
Authorized Official - Last Name:KOJI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:651-332-4220
Mailing Address - Street 1:101 124TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:55434-1984
Mailing Address - Country:US
Mailing Address - Phone:651-332-4220
Mailing Address - Fax:651-578-2269
Practice Address - Street 1:413 CENTRAL AVE W
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55103-2219
Practice Address - Country:US
Practice Address - Phone:651-332-4220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-25
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN359613311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home