Provider Demographics
NPI:1467872556
Name:UNIVERSAL ADULT DAY CARE LLC
Entity Type:Organization
Organization Name:UNIVERSAL ADULT DAY CARE LLC
Other - Org Name:UNIVERSAL ADULT DAYCARE LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:HANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MUMIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-319-1075
Mailing Address - Street 1:465 MACKUBIN ST
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55103-2252
Mailing Address - Country:US
Mailing Address - Phone:507-319-1075
Mailing Address - Fax:
Practice Address - Street 1:465 MACKUBIN ST
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55103-2252
Practice Address - Country:US
Practice Address - Phone:507-319-1075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-16
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services