Provider Demographics
NPI:1891512901
Name:LUXE HOME RESIDENTIAL SERVICES LLC
Entity type:Organization
Organization Name:LUXE HOME RESIDENTIAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANANGER
Authorized Official - Prefix:
Authorized Official - First Name:SALEBAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:OMAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-404-6590
Mailing Address - Street 1:1144 36 1/2 AVE NE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55418-1303
Mailing Address - Country:US
Mailing Address - Phone:612-404-6590
Mailing Address - Fax:
Practice Address - Street 1:1144 36 1/2 AVE NE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55418-1303
Practice Address - Country:US
Practice Address - Phone:612-404-6590
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-21
Last Update Date:2024-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility