Healthcare Provider Details

I. General information

NPI: 1659268795
Provider Name (Legal Business Name): ALLWELL HOME SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2025
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

942 REDWOOD DR
APPLE VALLEY MN
55124-9124
US

IV. Provider business mailing address

PO BOX 242
COTTAGE GROVE MN
55016-0242
US

V. Phone/Fax

Practice location:
  • Phone: 651-808-1775
  • Fax:
Mailing address:
  • Phone: 651-808-1775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: AMBER DEMARS
Title or Position: CHIEF OF OPERATIONS
Credential:
Phone: 651-808-1775