| NPI | 1285410746 |
|---|---|
| Doing Business As | PROVENANCE HOMES |
| Entity Type | Organization |
| Authorized Contact | SABRINA LUKALU GLOBUS Owner 612-741-7311 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 251E00000X Home Health |
| Enumeration Date | 2023-08-31 |
| Last Update Date | 2023-10-31 |