Organization
HOMEBASE SUPPORT SERVICES LLC
Active
Parent organization
HOMEBASE HOUSING SERVICES INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
HOMEBASE HOUSING SERVICES INC
Authorized official
RYAN CHRISTOPHER MENZEL (PRESIDENT)
(218) 831-8710
Entity
Organization
Contact information
Practice address
14889 NOKAY LAKE RD, BRAINERD, MN 56401-5595
(218) 831-8710
Mailing address
14889 NOKAY LAKE RD, BRAINERD, MN 56401-5595
(218) 831-8710
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
05/18/2024
Last updated
05/24/2024
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