Organization
ERICKSON CORPORATION
Active
Other names
Erickson Home Care
Organization subpart
No
Provider details
NPI number
Authorized official
LUKE ERICKSON (OWNER)
(763) 222-6562
Entity
Organization
Contact information
Practice address
718 129TH AVE NE, BLAINE, MN 55434-3250
(763) 222-6562
Mailing address
718 129TH AVE NE, BLAINE, MN 55434-3250
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1080489-1-HCBS
MN
253J00000X
Foster Care Agency
1080489-1-HCBS
MN
Other
Enumeration date
12/23/2016
Last updated
12/23/2016
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