Organization
PETRA HOMECARE SERVICES LLC
Active
Other names
Petra Recuperative Services
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH NANA YAA FLECK REGISTERED NURSE (OWNER)
(612) 390-4489
Entity
Organization
Contact information
Practice address
12856 MANKATO ST NE, BLAINE, MN 55449-4936
(612) 390-4489
Mailing address
12856 MANKATO ST NE, BLAINE, MN 55449-4936
(612) 390-4489
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
251J00000X
Nursing Care Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
385H00000X
Respite Care
Primary
—
—
Other
Enumeration date
05/29/2025
Last updated
05/29/2025
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