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PROVENANCE HOMES
NPI 1285410746
In Home Supportive Care in St Louis Park, MN

Active since August 31, 2023
1650 W END BLVD STE 100, ST LOUIS PARK, MN 55416(612) 261-6988(612) 465-1402 Get Directions Write a Review

NPPES record last updated: October 31, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 31, 2023, Aug 31, 2023 (2 updates tracked since 2023).

About Provenance Homes NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROVENANCE HOMES (NPI 1285410746) is a healthcare organization registered as an in home supportive care in St Louis Park, Minnesota and active in the NPI registry since August 2023. The organization lists Sabrina Lukalu Globus, Owner, as its authorized official.

NPPES Registry Identity

NPI1285410746
Entity TypeOrganization
Primary Taxonomy253Z00000X
Legal Business NamePROVENANCE HOMES
Location Address1650 W END BLVD STE 100St Louis Park, MN 55416-5369
Mailing Address1650 W End Blvd Ste 100St Louis Park, MN 55416-5369 · (612) 261-6988 · Fax (612) 465-1402
Phone(612) 261-6988
Fax(612) 465-1402
Organization SubpartYesParent: Provenance Healthcare Staffing Llc
Authorized OfficialSabrina Lukalu GlobusOwner · (612) 741-7311
Enumeration DateAugust 31, 2023
Last NPPES UpdateOctober 31, 20232 updates tracked since enumeration
NPPES CertifiedOctober 24, 2023
✔ NPI 1285410746 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyIn Home Supportive CareAgencies
Taxonomy Code253Z00000X
Definition
An In Home Supportive Care Agency provides services in the patient's home with the goal of enabling the patient to remain at home. The services provided may include personal care services such as hands-on assistance with activities of daily living (ADLs), e.g., eating, bathing, dressing, and bladder and bowel requirements; homemaker services and instrumental activities of daily living (IADLs), e.g., taking medications, shopping for groceries, laundry, housekeeping, and companionship; and/or supervision or cuing so that a person can perform tasks themselves.
Also ListedHome HealthTaxonomy 251E00000X
1650 W END BLVD STE 100, St Louis Park, MN 55416
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Other Names 1

Doing Business AsProvenance Homes

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. JESSICA MARIE COLEMAN
Social Worker (Clinical)
1650 W END BLVD STE 100
ST LOUIS PARK, MN 55416
Hennepin County (763) 331-2161
COMMUNITY AUTISM THERAPY CENTER LLC
Early Intervention Provider Agency
1650 W END BLVD STE 100
MINNEAPOLIS, MN 55416
Hennepin County (952) 994-0909
POLARIS AUTISM CENTER
Community/Behavioral Health
1650 W END BLVD STE 100
ST LOUIS PARK, MN 55416
Hennepin County (952) 228-1299
ELM CREEK HEALTHCARE INC
Home Health
1650 W END BLVD STE 100
ST LOUIS PARK, MN 55416
Hennepin County (612) 305-8260
THRIVE BEHAVIORAL HEALTH SERVICES
Nurse Practitioner (Psychiatric/Mental Health)
1650 W END BLVD STE 100
ST LOUIS PARK, MN 55416
Hennepin County (612) 477-5139
KANIA MAE JOHNSON
Social Worker
1650 W END BLVD STE 100
ST LOUIS PARK, MN 55416
Hennepin County (763) 331-2161
AWAKEN RECOVERY COUNSELING CENTER LLC
Counselor (Mental Health)
1650 W END BLVD STE 100
ST LOUIS PARK, MN 55416
Hennepin County (763) 331-2161
GOOD SAMARITAN CARE CENTER LLC
Clinic/Center
1650 W END BLVD STE 100
ST LOUIS PARK, MN 55416
Hennepin County (612) 804-9439

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Provenance Homes's NPI number?

The NPI number for Provenance Homes is 1285410746. It was assigned to this organization in the NPPES registry on August 31, 2023.

Where is Provenance Homes located?

Provenance Homes is located at 1650 W End Blvd Ste 100, St Louis Park, MN 55416. The listed phone number is (612) 261-6988.

What is Provenance Homes's specialty?

The primary specialty registered for this NPI is In Home Supportive Care with taxonomy code 253Z00000X.

When was this NPI record last updated?

The NPPES record for Provenance Homes was last updated on October 31, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.