Wabo Alf LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

WABO ALF LLC

Practice address

8371 5TH Street NE
Spring Lake Park, MN 55432

Phone

(612) 919-7002

Fax

(612) 329-0183

NPI assigned

Aug 11, 2023

Last updated

Oct 5, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Christine Kengne

Title

Owner

Phone

(612) 919-7002

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1691712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696464000000",
    "number": "1427731793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8371 5TH STREET NE",
            "city": "SPRING LAKE PARK",
            "state": "MN",
            "postal_code": "55432",
            "telephone_number": "612-919-7002",
            "fax_number": "612-329-0183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8371 5TH STREET NE",
            "city": "SPRING LAKE PARK",
            "state": "MN",
            "postal_code": "55432",
            "telephone_number": "612-919-7002",
            "fax_number": "612-329-0183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WABO ALF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-11",
        "last_updated": "2023-10-05",
        "status": "A",
        "authorized_official_last_name": "KENGNE",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-919-7002",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.