Organization
FORTUNATE HOMES LLC
Active
Parent organization
FORTUNATE HOMES LLC
Other names
FORTUNATE HOMES-HCBS
Organization subpart
Yes
Provider details
NPI number
Legal business name
FORTUNATE HOMES LLC
Authorized official
SUSAN OBWAYA (CEO/DESIGNATOR MANAGER)
(952) 994-5356
Entity
Organization
Contact information
Practice address
7006 E FISH LAKE RD, MAPLE GROVE, MN 55311-2832
(952) 994-5356
(952) 674-7774
Mailing address
7006 E FISH LAKE RD, MAPLE GROVE, MN 55311-2832
(952) 994-5356
(952) 674-7774
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
02/18/2025
Last updated
02/18/2025
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