12th House Healing Services
Nursing Care in Saint Paul, MN. Organization (NPI-2).
NPI number1871367714
StatusActive
Last updated in NPPESNov 10, 2023
Details
- NPI
- 1871367714
- Entity type
- Organization (NPI-2)
- Legal business name
- 12th House Healing Services
- Organization subpart
- No
- Enumeration date
- Nov 10, 2023
- Certification date
- Nov 10, 2023
- Last updated
- Nov 10, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251J00000X | Nursing Care | – | – | Yes |
| 177F00000X | Lodging | – | – | |
| 253Z00000X | In Home Supportive Care | – | – | |
| 3104A0625X | Assisted Living Facility, Assisted Living, Mental Illness | – | – | |
| 3104A0630X | Assisted Living Facility, Assisted Living, Behavioral Disturbances | – | – | |
| 320800000X | Community Based Residential Treatment Facility, Mental Illness | – | – |
Practice location
650 Aguirre St Apt 232Saint Paul, MN 55130-4430
Phone 612-584-0902
Mailing address
650 Aguirre St Apt 232Saint Paul, MN 55130-4430
Phone 612-584-0902
Authorized official
Tayonna Martia Mays
Ceo
6125840902
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