Provenance Homes

LBN: Provenance Homes
Provenance Homes is an health care organization with primary practice located at 1650 W End Blvd Ste 100 , St Louis Park MN 55416-5369. The organization recently has 2 registered licenses in different health care specialties including Agencies / Home Health, Agencies / In Home Supportive Care. Agencies / In Home Supportive Care is the primary health care specialty. Provenance Homes can be contacted via phone (612) 261-6988, or through Globus, Sabrina Lukalu via phone (612) 741-7311.

Contact Information

Primary practice address
1650 W End Blvd Ste 100 St Louis Park MN 55416-5369
Phone: (612) 261-6988
Fax: (612) 465-1402
Website:
Map and Directions
Authorized official contact:
Name: Globus, Sabrina Lukalu
Phone: (612) 741-7311

Health care specialties

SpecialtyCodeLicense #State
Agencies / Home Health 251E00000X
Agencies / In Home Supportive Care 253Z00000X

Profile Details

NPI number 1285410746
LBN Legal business name Provenance Homes
DBA Doing business as Provenance Homes
Authorized official Globus, Sabrina Lukalu
Entity Organization
Organization subpart 1 Yes
Enumeration date Aug 31st, 2023
Last updated Oct 31st, 2023 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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