Provider Demographics
NPI:1700204450
Name:GVP SENIOR CARE CENTER, INC.
Entity type:Organization
Organization Name:GVP SENIOR CARE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TOUNEY
Authorized Official - Middle Name:T
Authorized Official - Last Name:XIONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-444-8183
Mailing Address - Street 1:1600 WHITE BEAR AVE N
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55106-1608
Mailing Address - Country:US
Mailing Address - Phone:651-444-8183
Mailing Address - Fax:651-444-8182
Practice Address - Street 1:1600 WHITE BEAR AVE N
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55106-1608
Practice Address - Country:US
Practice Address - Phone:651-444-8183
Practice Address - Fax:651-444-8182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-31
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1066212-1-ADC261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care