| Enriching Home Care Services, Llc | |
|
6045 Vicksburg Ln N Plymouth MN 55446-1140 | |
| (763) 232-4946 | |
| (763) 325-9602 |
| Full Name | Enriching Home Care Services, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 6045 Vicksburg Ln N, Plymouth, Minnesota |
| Authorized Official Name and Position | Kejyana Clark (OWNER) |
| Authorized Official Contact | 7632324946 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Enriching Home Care Services, Llc 6045 Vicksburg Ln N Plymouth MN 55446-1140 Ph: (763) 232-4946 | Enriching Home Care Services, Llc 6045 Vicksburg Ln N Plymouth MN 55446-1140 Ph: (763) 232-4946 |
| NPI Number | 1154161131 |
|---|---|
| Provider Enumeration Date | 05/28/2024 |
| Last Update Date | 06/04/2024 |
| Certification Date | 06/04/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154161131 | NPI | - | NPPES |
| 1437872413 | Medicaid | MN |
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