Organization
HOMESTEAD DIVERSITY LLC
Active
Organization
HOMESTEAD DIVERSITY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COURTNY SQUIBB (COO)
(515) 230-8902
Entity
Organization
Contact information
Practice address
3408 E 125TH ST, BURNSVILLE, MN 55337-3410
(515) 230-8902
Mailing address
3408 E 125TH ST, BURNSVILLE, MN 55337-3410
(515) 230-8902
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
05/22/2023
Last updated
05/22/2023
Update your record
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