Provider Demographics
NPI:1972073096
Name:SELECT HOME CARE, LLC
Entity type:Organization
Organization Name:SELECT HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LASHAY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKENZIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-237-8034
Mailing Address - Street 1:7714 BROOKLYN BLVD STE 200-D
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55443-2936
Mailing Address - Country:US
Mailing Address - Phone:763-777-8293
Mailing Address - Fax:763-777-8296
Practice Address - Street 1:7714 BROOKLYN BLVD STE 200-D
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55443-2936
Practice Address - Country:US
Practice Address - Phone:763-777-8293
Practice Address - Fax:763-777-8296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-01
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility