Organization
PLEASANT LIGHT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSPHAT NYAMBATI OMARI REGISTERED NURSE (ADMINISTRATOR)
(952) 406-8951
Entity
Organization
Contact information
Practice address
14501 GRAND AVE APT 529, BURNSVILLE, MN 55306-6604
(952) 406-8951
(952) 229-4391
Mailing address
14501 GRAND AVE APT 529, BURNSVILLE, MN 55306-6604
(952) 406-8951
(952) 229-4391
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
01/10/2020
Last updated
08/24/2022
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