Provider Demographics
NPI:1912669037
Name:IN HOUSE SENIOR SERVICES, LLC
Entity Type:Organization
Organization Name:IN HOUSE SENIOR SERVICES, LLC
Other - Org Name:IN HOUSE SENIOR SERVICES LAB
Other - Org Type:Other Name
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:WECKWERTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-200-8029
Mailing Address - Street 1:6625 LYNDALE AVE S STE 300
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55423-2491
Mailing Address - Country:US
Mailing Address - Phone:612-243-8999
Mailing Address - Fax:612-869-3473
Practice Address - Street 1:6625 LYNDALE AVE S STE 305
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55423-2373
Practice Address - Country:US
Practice Address - Phone:612-243-8999
Practice Address - Fax:612-869-3473
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:IN HOUSE SENIOR SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-10-06
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory