# SUCCESS HOME CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215394655
- **Authorized official:** OSETOHAMEN ELIZABETH AGENE RN (OWNER)
- **Authorized official phone:** (763) 614-6988

## Contact information

- **Practice address:** 5701 SHINGLE CREEK PKWY STE 350A, BROOKLYN CENTER, MN 55430-2485
- **Practice address phone:** (763) 444-1914
- **Mailing address:** 5701 SHINGLE CREEK PKWY STE 350A, BROOKLYN CENTER, MN 55430-2485
- **Mailing address phone:** (763) 444-1914

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 01/15/2016
- **Last updated:** 01/15/2016