MISS PHINSAYKEO SOURIYATHAY (NPI# 1265079404) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265079404 |
| Entity Type | Individual |
| Full Name | MISS PHINSAYKEO SOURIYATHAY |
| Practice Address |
9300 Penn Ave N Brooklyn Park MN 55444-1166 |
| Mailing Address |
6231 Sunny Ln Brooklyn Park MN 55428-2732 |
| Practice Telephone | 6123681236 |
| Mailing Telephone | 6123681236 |
| Enumeration Date | 2019-12-06 |
| Last Update Date | 2019-12-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | D1245705 | 05 |
| Street Address |
9300 PENN AVE N |
| City | BROOKLYN PARK |
| State | MN |
| Zip Code | 55444-1166 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124541404 | Sharon Novell | Private Vehicle | 8411 Sheridan Av N, Minneapolis, MN 55444 | 2017-07-19 |
| 1053692491 | Akwen Joan Morcho | Registered Nurse | 9733 Thomas Ave N, Brooklyn Park, MN 55444-1011 | 2011-08-30 |
| 1497811244 | B D Edwards and Co.,llc | Home Health | 2716 98th Ave N, Brooklyn Park, MN 55444-1020 | 2006-12-28 |
| 1346870201 | The Grace Home Health Services LLC | Home Health | 9707 Penn Ave N, Brooklyn Park, MN 55444-1031 | 2020-01-20 |
| 1003118787 | Jessica Marie Coleman | Doula | 2401 96th Ave N, Brooklyn Park, MN 55444-1148 | 2010-12-01 |
| 1386101129 | Aspen Home Health Care Inc. | In Home Supportive Care | 9508 Upton Ave N, Brooklyn Park, MN 55444-1157 | 2019-02-28 |
| 1326258336 | Pang Tang Her | Technician | 9217 W River Rd, Brooklyn Park, MN 55444-1219 | 2007-05-22 |
| 1508341157 | Todd David Hanson | Registered Nurse | 1601 89th Ave N, Brooklyn Park, MN 55444-1233 | 2018-09-29 |
| 1134750789 | Lamonica Barthelemy | Technician | 9232 James Ave N, Brooklyn Park, MN 55444-1234 | 2020-02-03 |
| 1104457217 | Bella Beauty and Hair LLC | Durable Medical Equipment & Medical Supplies | 1436 85th Ave N, Brooklyn Park, MN 55444-1416 | 2020-01-28 |
| Find all providers in zip 55444 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326651779 | Secured Health and Homecare Inc | Assisted Living Facility | 4519 104th Ave N, Brooklyn Park, MN 55443-1030 | 2020-08-26 |
| 1134740939 | Suite Living Senior Care of Brooklyn Park | Assisted Living Facility | 8500 Regent Ave N, Brooklyn Park, MN 55443-2391 | 2020-05-03 |
| 1730716804 | Kindheart Homes Inc | Assisted Living Facility | 2308 87th Trl N, Brooklyn Park, MN 55443-3732 | 2020-03-26 |
| 1992344402 | Joy Care Homes LLC | Assisted Living Facility | 6825 71st Ave N, Brooklyn Park, MN 55428-1736 | 2019-12-31 |
| 1205474236 | Joy Care Homes LLC | Assisted Living Facility | 4301 78th Ave N, Brooklyn Park, MN 55443-3403 | 2019-12-20 |
| 1306493077 | Royal Home Care Inc | Assisted Living Facility | 7832 Penn Ave N, Brooklyn Park, MN 55444-1847 | 2019-08-19 |
| 1932688223 | Bethel Pavilion Homecare LLC | Assisted Living Facility | 3816 83rd Ave N, Brooklyn Park, MN 55443-2753 | 2018-08-08 |
| 1356686836 | Minnesota Senior Living LLC | Assisted Living Facility | 6288 Louisiana Ct N, Brooklyn Park, MN 55428-2550 | 2012-12-10 |
| 1548505027 | Minnesota Senior Living LLC | Assisted Living Facility | 8500 Tessman Farm Rd N, Brooklyn Park, MN 55445-2297 | 2012-12-10 |
| 1487913885 | Empowerment Healthcare, LLC | Assisted Living Facility | 8125 France Ave N, Brooklyn Park, MN 55443-2714 | 2012-05-07 |
| Find all providers in BROOKLYN PARK | ||||
| City | BROOKLYN PARK |
| Zip Code | 55444 |
Please comment or provide details below to improve the information on MISS PHINSAYKEO SOURIYATHAY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.