Organization
LIFESPAN HOME CARE SERVICES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AKPENE Y ASEMPA RN (MANAGER)
(651) 210-7122
Entity
Organization
Contact information
Practice address
93 LITTLE CANADA RD W, SUITE 103, LITTLE CANADA, MN 55117-1683
(651) 765-6034
(651) 765-2873
Mailing address
93 LITTLE CANADA RD W, SUITE 103, LITTLE CANADA, MN 55117-1683
(651) 765-6034
(651) 765-2873
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
798102000
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1669684817
NPI
MN
01
—
798102000
MHCP
MN
Enumeration date
05/03/2007
Last updated
01/25/2016
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