DAVIS JACKSON MEDICAL ASSIST TEAN LEE NPI 1114528973

NPI Information

DAVIS JACKSON MEDICAL ASSIST TEAN LEE is an adult companion in Saint Paul, MN. The provider is an individual who provides supervision, socialization, and non-medical care to a functionally impaired adult. Companions may assist or supervise the individual with such tasks as meal preparation, laundry and shopping, but do not perform these activities as discrete services. These services are provided in accordance with a therapeutic goal in the plan of care. DAVIS JACKSON MEDICAL ASSIST TEAN LEE NPI is 1114528973. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

6449 IPTH DR.
SAINT PAUL, MN
ZIP 55725-130
Phone: (657) 592-5960
Fax: (651) 286-2994

The provider's authorized official is Florense Monique Davis .
The authorized official title is President/owner and has the following contact phone number (651) 595-5960.

The enumeration date for this NPI number is 11/6/2020 and was last updated on 11/6/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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