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Phouvieng Sivilay
Assisted Living Facility in Eden Prairie, Minnesota
NPI 1245012715

Phouvieng Sivilay is an Assisted Living Facility based in Eden Prairie, MN. Phouvieng Sivilay practices in Eden Prairie, MN. The NPI Number for Phouvieng Sivilay is 1245012715 and holds a License No. 39902 (Minnesota).

The current practice location address for Phouvieng Sivilay is 10452 Spyglass Dr, Eden Prairie, MN and can be reached out via phone at 612-508-8743.

Location: 10452 Spyglass Dr, Eden Prairie, MN, 55347-4855
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1245012715
Provider Name
Phouvieng Sivilay
Credential
Provider Entity Type
Individual
Gender
Male
Address
10452 Spyglass Dr, Eden Prairie, MN, 55347-4855
Phone Number
612-508-8743
Fax Number
Provider Enumeration Date
10/18/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
10452 Spyglass Dr
City
Eden Prairie
State
Minnesota
Zip
55347-4656
Phone Number
612-508-8743
Fax Number
person
Provider Business Mailing Address Details
Address
10452 Spyglass Dr
City
Eden Prairie
State
Minnesota
Zip
55347-4656
Phone Number
612-508-8743
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Assisted Living Facility
Speciality
-
Taxonomy
310400000X
License No.
39902 (Minnesota)
Definition
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.
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