Provider Demographics
NPI:1932529856
Name:HOME TO SWEET HOME LLC
Entity Type:Organization
Organization Name:HOME TO SWEET HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BEVENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-351-0038
Mailing Address - Street 1:109 MARYKNOLL DR
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082-5252
Mailing Address - Country:US
Mailing Address - Phone:651-351-0038
Mailing Address - Fax:
Practice Address - Street 1:109 MARYKNOLL DR
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:MN
Practice Address - Zip Code:55082-5252
Practice Address - Country:US
Practice Address - Phone:651-351-0038
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-17
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care