Provider Demographics
NPI:1669616975
Name:PERCY NELSON ENTERPRIES INC
Entity type:Organization
Organization Name:PERCY NELSON ENTERPRIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PERCY
Authorized Official - Middle Name:LAMAR
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:651-209-6360
Mailing Address - Street 1:7616 CURRELL BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-2290
Mailing Address - Country:US
Mailing Address - Phone:651-209-6360
Mailing Address - Fax:866-941-5649
Practice Address - Street 1:7616 CURRELL BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-2290
Practice Address - Country:US
Practice Address - Phone:651-209-6360
Practice Address - Fax:866-941-5649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-30
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN26376253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care