Provider Demographics
NPI:1932807088
Name:VILLAGE INTEGRATED SERVICES AGENCY LLP
Entity type:Organization
Organization Name:VILLAGE INTEGRATED SERVICES AGENCY LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:STINSON-ROYSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-443-4236
Mailing Address - Street 1:5803 XERXES AVE N APT 115
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55430-2844
Mailing Address - Country:US
Mailing Address - Phone:763-443-4236
Mailing Address - Fax:763-647-7146
Practice Address - Street 1:3300 COUNTY RD 10
Practice Address - Street 2:SUITE 500G
Practice Address - City:BROOKLYN CENTER
Practice Address - State:MN
Practice Address - Zip Code:55429
Practice Address - Country:US
Practice Address - Phone:763-443-4236
Practice Address - Fax:763-647-7146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-17
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No174200000XOther Service ProvidersMeals
No177F00000XOther Service ProvidersLodging