| NPI | 1861139560 |
|---|---|
| Former Legal Business Name | MENAGE LLC |
| Entity Type | Organization |
| Authorized Contact | TRAVIS ANTHONY DOLLERSON CEO 651-600-1161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 174200000X Meals |
| 251T00000X PACE Provider Organization | |
| 253Z00000X In Home Supportive Care | |
| Enumeration Date | 2022-05-16 |
| Last Update Date | 2022-08-25 |