Provider Demographics
NPI:1215245113
Name:CELEBRITY HOME HEALTH PARTNERS, LLC
Entity type:Organization
Organization Name:CELEBRITY HOME HEALTH PARTNERS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAYTON
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:612-799-6508
Mailing Address - Street 1:5775 WAYZATA BLVD
Mailing Address - Street 2:SUITE 700
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-1222
Mailing Address - Country:US
Mailing Address - Phone:612-706-0910
Mailing Address - Fax:
Practice Address - Street 1:5775 WAYZATA BLVD
Practice Address - Street 2:SUITE 700
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-1222
Practice Address - Country:US
Practice Address - Phone:612-706-0910
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-14
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN348032OtherMN DHS CLASS A PROFESSIONAL HOME CARE AGENCY LICENSE