MEDICARE: CAMBRIAN HOMECARE, 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1770306938
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAMBRIAN HOMECARE, LLC

Provider Business Mailing Address
First Line	:	1444 NORTHLAND DR STE 200
Second Line	:
City	:	MENDOTA HEIGHTS
State	:	MN
Zip	:	55120-1032
Country	:	US
Telephone Number	:	651-699-0206
Fax Number	:

Provider Business Practice Location Address
First Line	:	2883 E SPRING ST STE 260
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90806-6847
Country	:	US
Telephone Number	:	651-699-0206
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	LORI KRESS
Credential	:
Telephone Number	:	651-699-0206

Provider Enumeration Date	:	11/06/2024
Last Update Date	:	11/06/2024

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