Organization
ROXANNE ELOUISE LILLIS
Active
Other names
At Home Agency
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ROXANNE ELOUISE LILLIS (OWNER)
(218) 226-4496
Entity
Organization
Contact information
Practice address
4215 BEAVER VALLEY RD, SILVER BAY, MN 55614-3808
(218) 226-4496
Mailing address
4215 BEAVER VALLEY RD, SILVER BAY, MN 55614-3808
(218) 226-4496
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
342529
MN
Other
Enumeration date
01/13/2009
Last updated
01/13/2009
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