Provider Demographics
NPI:1154628915
Name:THE JAMES INC ASSITED LIVING
Entity type:Organization
Organization Name:THE JAMES INC ASSITED LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:IMASUEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:953-233-5376
Mailing Address - Street 1:4533 NORMANDALE HIGHLANDS DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55437-2310
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4533 NORMANDALE HIGHLANDS DR
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55437-2310
Practice Address - Country:US
Practice Address - Phone:952-831-4591
Practice Address - Fax:952-831-3275
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE JAMES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-02-14
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility