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General NPI Number Information
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NPI Number | 1447073150
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Entity Type | Organization
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Legal Business Name | LUX AGENCY LLC
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Dates
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Enumeration Date | 11/02/2024
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Last Update Date | 04/28/2025
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Provider Practice Location Address
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Address Line | 4272 31ST AVE S
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City | FARGO
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State | ND
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Zip | 58104-8725
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Country | US
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Telephone | 701-200-3783
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Fax |
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Provider Business Mailing Address
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Address Line | 4272 31ST AVE S
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City | FARGO
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State | ND
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Zip | 58104-8725
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Country | US
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Telephone | 701-200-3783
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DESIRE BIZIMANA NKINZINGABO
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Credential |
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Telephone | 701-200-3783
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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