NPIMap

Organization Active NPI

Success Home Care LLC

  • In Home Supportive Care Agency
  • Brooklyn Center, MN
National Provider Identifier
1215394655
Registry record updated Jan 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
SUCCESS HOME CARE LLC
Practice address
5701 Shingle Creek Pkwy Ste 350a
Brooklyn Center, MN 55430-2485
Phone
(763) 444-1914
NPI assigned
Jan 15, 2016
Last updated
Jan 15, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Osetohamen Elizabeth Agene, RN
Title
Owner
Phone
(763) 614-6988

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

5701 Shingle Creek Pkwy Ste 350a
Brooklyn Center, MN 55430-2485

Mailing address

5701 Shingle Creek Pkwy Ste 350a
Brooklyn Center, MN 55430-2485
Phone (763) 444-1914

National Provider Directory

National Provider Directory
Tax ID family
Success Home Care LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1452816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452816000000",
    "number": "1215394655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 SHINGLE CREEK PKWY STE 350A",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554302485",
            "telephone_number": "763-444-1914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 SHINGLE CREEK PKWY STE 350A",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554302485",
            "telephone_number": "763-444-1914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUCCESS HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-15",
        "last_updated": "2016-01-15",
        "status": "A",
        "authorized_official_last_name": "AGENE",
        "authorized_official_first_name": "OSETOHAMEN",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "763-614-6988",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn Center, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.