MEDICARE: ECUMEN 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	334253	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	115411	OTHER	HEALTH PARTNERS
2	4980059	OTHER	MEDICA
3	170748	OTHER	UCARE

General Provider Information

NPI Number	:	1255452280
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ECUMEN HOME CARE, INC

Provider Business Mailing Address
First Line	:	3530 LEXINGTON AVE N
Second Line	:
City	:	SHOREVIEW
State	:	MN
Zip	:	55126-8164
Country	:	US
Telephone Number	:	651-766-4300
Fax Number	:

Provider Business Practice Location Address
First Line	:	2533 1ST AVE S
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55404-4342
Country	:	US
Telephone Number	:	612-821-2190
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	KATHRYN R ROBERTS
Credential	:
Telephone Number	:	651-766-4300

Provider Enumeration Date	:	04/03/2007
Last Update Date	:	08/22/2020

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