Provider Demographics
NPI:1518663616
Name:LEE, SAYCHEE
Entity Type:Individual
Prefix:
First Name:SAYCHEE
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2451 GERMAIN ST
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55109-2018
Mailing Address - Country:US
Mailing Address - Phone:651-308-2161
Mailing Address - Fax:888-972-5310
Practice Address - Street 1:2451 GERMAIN ST
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-2018
Practice Address - Country:US
Practice Address - Phone:651-308-2161
Practice Address - Fax:888-972-5310
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-01
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X, 372500000X, 372600000X, 376J00000X
MN1067235163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No251E00000XAgenciesHome Health
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No376J00000XNursing Service Related ProvidersHomemaker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNA005492100Medicaid
MNA853177100Medicaid