Provider Demographics
NPI:1962712539
Name:CHAO AND DOUA FAMILY ADULT FOSTER CARE
Entity type:Organization
Organization Name:CHAO AND DOUA FAMILY ADULT FOSTER CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHAO
Authorized Official - Middle Name:
Authorized Official - Last Name:VANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-245-7701
Mailing Address - Street 1:7106 NEWTON AVE NORTH
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55430
Mailing Address - Country:US
Mailing Address - Phone:763-245-7701
Mailing Address - Fax:763-569-0127
Practice Address - Street 1:7106 NEWTON AVE NORTH
Practice Address - Street 2:
Practice Address - City:BROOKLYN CENTER
Practice Address - State:MN
Practice Address - Zip Code:55430
Practice Address - Country:US
Practice Address - Phone:763-245-7701
Practice Address - Fax:763-569-0127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-18
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN781158600311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home