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Miss Phinsaykeo Souriyathay
Assisted Living Facility in Brooklyn Park, Minnesota
NPI 1265079404

Phinsaykeo Souriyathay is an Assisted Living Facility based in Brooklyn Park, MN. Phinsaykeo Souriyathay practices in Brooklyn Park, MN. The NPI Number for Phinsaykeo Souriyathay is 1265079404 and holds a License No. (Minnesota).

The current practice location address for Phinsaykeo Souriyathay is 9300 Penn Ave N, Brooklyn Park, MN and can be reached out via phone at 612-368-1236.

Location: 9300 Penn Ave N, Brooklyn Park, MN, 55428-2732
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1265079404
Provider Name
Phinsaykeo Souriyathay
Credential
Provider Entity Type
Individual
Gender
Female
Address
9300 Penn Ave N, Brooklyn Park, MN, 55428-2732
Phone Number
612-368-1236
Fax Number
Provider Enumeration Date
12/06/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
D1245705 05 CA
institution
Provider Business Practice Location Address Details
Address
9300 Penn Ave N
City
Brooklyn Park
State
Minnesota
Zip
55444-1166
Phone Number
612-368-1236
Fax Number
person
Provider Business Mailing Address Details
Address
9300 Penn Ave N
City
Brooklyn Park
State
Minnesota
Zip
55444-1166
Phone Number
612-368-1236
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Assisted Living Facility
Speciality
-
Taxonomy
310400000X
License No.
()
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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