Healthcare Provider Details

I. General information

NPI: 1568228054
Provider Name (Legal Business Name): LUXCARE HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2024
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3012 126TH LN NE
BLAINE MN
55449-4200
US

IV. Provider business mailing address

3012 126TH LN NE
BLAINE MN
55449-4200
US

V. Phone/Fax

Practice location:
  • Phone: 612-353-9949
  • Fax: 612-454-5532
Mailing address:
  • Phone: 612-454-5436
  • Fax: 612-454-5532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. ZUHUR MOHAMED
Title or Position: AUTHORIZED AGENT
Credential:
Phone: 612-454-5436