MEDICARE: JOBEZ'S HOME CARE SERVICES LLC

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	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1295613099
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOBEZ'S HOME CARE SERVICES LLC

Provider Business Mailing Address
First Line	:	5701 SHINGLE CREEK PKWY STE 110
Second Line	:
City	:	BROOKLYN CENTER
State	:	MN
Zip	:	55430-2485
Country	:	US
Telephone Number	:	612-997-0311
Fax Number	:

Provider Business Practice Location Address
First Line	:	5701 SHINGLE CREEK PKWY STE 110
Second Line	:
City	:	BROOKLYN CENTER
State	:	MN
Zip	:	55430-2485
Country	:	US
Telephone Number	:	612-997-3420
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF OPERATIONS
Name	:	LAKESHA MACK
Credential	:
Telephone Number	:	612-997-0311

Provider Enumeration Date	:	08/21/2025
Last Update Date	:	11/10/2025

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