MEDICARE: JUBILEE HOME CARE INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1205481983
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JUBILEE HOME CARE INC.

Provider Business Mailing Address
First Line	:	1601 68TH LN N
Second Line	:
City	:	BROOKLYN CENTER
State	:	MN
Zip	:	55430-5800
Country	:	US
Telephone Number	:	612-272-8000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1601 68TH LN N
Second Line	:
City	:	BROOKLYN CENTER
State	:	MN
Zip	:	55430-5800
Country	:	US
Telephone Number	:	612-272-8000
Fax Number	:

Authorized Official
Title or Position	:	CEO/NURSE
Name	:	FLORENCE NGUM NCHOTU
Credential	:
Telephone Number	:	612-272-8000

Provider Enumeration Date	:	08/08/2019
Last Update Date	:	10/01/2019

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