Organization
FORTUNATE HOMES LLC
Active
Other names
Fortunate PCA Services
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN NYANG'ANYI OBWAYA (CEO/DIRECTOR)
(952) 994-5356
Entity
Organization
Contact information
Practice address
7006 E FISH LAKE RD, MAPLE GROVE, MN 55311-2832
(952) 994-5356
Mailing address
7006 E FISH LAKE RD, MAPLE GROVE, MN 55311-2832
(952) 994-5356
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
Primary
—
—
251J00000X
Nursing Care Agency
—
—
Other
Enumeration date
01/15/2025
Last updated
01/15/2025
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