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Organization
ESSENTIAL HOME LLC
Active
Organization
ESSENTIAL HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAI LEE VANG (OWNER)
(612) 456-4565
Entity
Organization
Contact information
Practice address
2345 RICE ST # 173, ROSEVILLE, MN 55113-3741
(612) 456-4565
(651) 846-4517
Mailing address
2345 RICE ST # 173, ROSEVILLE, MN 55113-3741
(612) 456-4565
(651) 846-4517
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
NULL
251G00000X
Community Based Hospice Care Agency
—
NULL
251S00000X
Community/Behavioral Health Agency
—
NULL
253Z00000X
In Home Supportive Care Agency
Primary
—
NULL
3104A0625X
Assisted Living Facility (Mental Illness)
—
NULL
324500000X
Substance Abuse Rehabilitation Facility
—
NULL
385H00000X
Respite Care
—
NULL
Other
Enumeration date
03/29/2022
Last updated
03/25/2024
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