Ebenezer Society, LLC

NPI #1477968550 in Wyoming, Minnesota

Provider Information

NPI Number: 1477968550
Entity Type: Organization
Organization Name: Ebenezer Society, LLC
Primary Specialty: Home Health
Enumeration Date: Jun 26, 2014
Last Updated: Jun 26, 2014

Practice Location

Address: 25565 FAIRVIEW AVE
City: Wyoming
State: Minnesota
ZIP Code: 55092-8053
Phone: (651) 982-6228

Authorized Official

Name: JILL NOKLEBY KAISER
Title: DIRECTOR OF HOUSING DEVELOPMENT
Phone: (612) 874-3431

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Home Health	251E00000X	Primary

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