Provider Demographics
NPI:1972745818
Name:METROPOLITAN CENTER FOR INDEPENDENT LIVING
Entity Type:Organization
Organization Name:METROPOLITAN CENTER FOR INDEPENDENT LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HR/FISCAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:SWEDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-603-2014
Mailing Address - Street 1:1600 UNIVERSITY AVE W STE 16
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-3834
Mailing Address - Country:US
Mailing Address - Phone:651-603-2014
Mailing Address - Fax:651-603-2014
Practice Address - Street 1:1600 UNIVERSITY AVE W STE 16
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-3834
Practice Address - Country:US
Practice Address - Phone:651-603-2014
Practice Address - Fax:651-603-2014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-24
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health