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Provenance Homes 1, Llc
Assisted Living Facility in Minneapolis, Minnesota
NPI 1356191928

Provenance Homes 1, Llc is an Assisted Living Facility based in St Louis Park, MN. Provenance Homes 1, Llc practices in Minneapolis, MN. The NPI Number for Provenance Homes 1, Llc is 1356191928 and holds a License No. (Minnesota).

The current practice location address for Provenance Homes 1, Llc is 3641 28Th Ave S Unit 1, Minneapolis, MN and can be reached out via phone at 612-940-2104.

Location: 3641 28Th Ave S Unit 1, Minneapolis, MN, 55416-5369
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1356191928
Provider Name
Provenance Homes 1, Llc
Credential
Provider Entity Type
Organization
Address
3641 28Th Ave S Unit 1, Minneapolis, MN, 55416-5369
Phone Number
612-940-2104
Fax Number
Provider Enumeration Date
03/25/2024
Last Update Date
04/14/2024
institution
Provider Business Practice Location Address Details
Address
3641 28Th Ave S Unit 1
City
Minneapolis
State
Minnesota
Zip
55406-2515
Phone Number
612-940-2104
Fax Number
person
Provider Business Mailing Address Details
Address
3641 28Th Ave S Unit 1
City
Minneapolis
State
Minnesota
Zip
55406-2515
Phone Number
612-940-2104
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Assisted Living Facility
Speciality
-
Taxonomy
310400000X
License No.
()
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
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