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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

PHOUVIENG SIVILAY

Active Sole Proprietor

PHOUVIENG SIVILAY is a Assisted Living Facility healthcare provider located in EDEN PRAIRIE, Minnesota. NPI 1245012715 is currently active in the NPPES registry. Verify at CMS.

Assisted Living Facility · EDEN PRAIRIE, MN

Registration Details

NPI Number
1245012715
Provider Type
Individual
Gender
Male
NPI Issued
Oct 18, 2023 (2.8093761577712 yrs)
Last Updated
Oct 18, 2023
License
39902 (MN)
Sole Proprietor
Yes

Practice Information

Address
10452 SPYGLASS DR
EDEN PRAIRIE, MN, 553474656
Browse MN providers · Browse ZIP 55347
Phone
6125088743
Primary Specialty
Assisted Living Facility
310400000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.