Agegrace, INC.
Health Maintenance Organization in Saint Paul, MN. Organization (NPI-2).
NPI number1033738554
StatusActive
Last updated in NPPESNov 5, 2020
Details
- NPI
- 1033738554
- Entity type
- Organization (NPI-2)
- Legal business name
- Agegrace, INC.
- Organization subpart
- No
- Enumeration date
- Apr 14, 2020
- Certification date
- Nov 5, 2020
- Last updated
- Nov 5, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 302R00000X | Health Maintenance Organization | – | – | Yes |
| 172V00000X | Community Health Worker | – | – | |
| 251E00000X | Home Health | – | – | |
| 251S00000X | Community/Behavioral Health | – | – | |
| 253Z00000X | In Home Supportive Care | – | – |
Other names
- Jao Companies (Other Name)
Practice location
635 Phalen Blvd Apt 401Saint Paul, MN 55130-5308
Phone 612-707-8121
Mailing address
Po Box 28041Oakdale, MN 55128-0041
Phone 612-707-8121
Authorized official
Jennifer Owens
Ceo/Administrator
6127078121
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