Provider Demographics
NPI:1508042540
Name:WINDELS HEALTH SERVICES
Entity Type:Organization
Organization Name:WINDELS HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DELAH
Authorized Official - Middle Name:M
Authorized Official - Last Name:AZUMAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-263-3854
Mailing Address - Street 1:1896 124TH LANE NE
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:55449
Mailing Address - Country:US
Mailing Address - Phone:651-263-3854
Mailing Address - Fax:
Practice Address - Street 1:12401 OAK PARK BLVD.
Practice Address - Street 2:APT. #310
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55449
Practice Address - Country:US
Practice Address - Phone:651-263-3854
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-20
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN338346251E00000X
MN005105000251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNA005105000OtherUMPI