Provenance Homes
NPI #1285410746 in St Louis Park, Minnesota
Provider Information
- NPI Number
- 1285410746
- Entity Type
- Organization
- Organization Name
- Provenance Homes
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- PROVENANCE HEALTHCARE STAFFING LLC
- Primary Specialty
- In Home Supportive Care
- Enumeration Date
- Aug 31, 2023
- Last Updated
- Oct 31, 2023
Practice Location
- Address
- 1650 W END BLVD STE 100
- City
- St Louis Park
- State
- Minnesota
- ZIP Code
- 55416-5369
- Phone
- (612) 261-6988
Authorized Official
- Name
- SABRINA LUKALU GLOBUS
- Title
- OWNER
- Phone
- (612) 741-7311
Specialties & Taxonomy Codes
| Specialty |
|---|
| Home Health |
| In Home Supportive Care |
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