Healthcare Provider Details

I. General information

NPI: 1669356192
Provider Name (Legal Business Name): WAYSTONE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2025
Last Update Date: 09/26/2026
Certification Date: 09/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 AMERICAN BLVD W STE 1544
BLOOMINGTON MN
55431-4420
US

IV. Provider business mailing address

3800 AMERICAN BLVD W STE 1544
BLOOMINGTON MN
55431-4420
US

V. Phone/Fax

Practice location:
  • Phone: 612-425-0026
  • Fax: 612-425-0453
Mailing address:
  • Phone: 612-425-0026
  • Fax: 612-425-0453

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ABDIRAHMAN JAMA
Title or Position: CO-OWNER
Credential:
Phone: 612-425-0026