NPI: 1710010202 · SAINT PAUL, MN 55113 · Nursing Facility/Intermediate Care Facility · NPI assigned 03/13/2007
| Authorized Official | TESFAYE, KIROS (BUSINESS MANAGER) |
| NPI Enumeration Date | 03/13/2007 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 517 | $691.50 |
| 2019 | 122 | $7K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| S5130 | Homemaker service, nos; per 15 minutes | 639 | 126 | $8K |