Provenance Homes

Practice location

Address

1650 W End Blvd STE 100, St Louis Park, MN 55416-5369

Phone

(612) 261-6988

Fax

(612) 465-1402

Authorised official

Name

Sabrina Lukalu Globus

Title

Owner

Phone

(612) 741-7311

Registered specialties (2)

Registry record

NPI

1285410746

Entity type

Organization

NPI issued

31 Aug 2023

Record last updated

31 Oct 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.