NPI 1982991279

Five Star Alternative Care Nursing Co

Organisation Exclusive Provider Organization Woodbury, MN

Practice location

Address: 6617 Stratford Road, Woodbury, MN 55125
Phone: (650) 814-0056
Mailing address: 725 Wildwood Lane, Palo, CA 94303

Authorised official

Name: Sandra R Gavney
Title: Owner
Phone: (650) 814-0056

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence 1040251-6-AFC (MN)

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Registry record

NPI: 1982991279
Entity type: Organization
NPI issued: 7 Jul 2011
Record last updated: 7 Jul 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.