Healthcare Provider Details

I. General information

NPI: 1760349096
Provider Name (Legal Business Name): HALO HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4470 W 78TH STREET CIR STE 200
BLOOMINGTON MN
55435-5419
US

IV. Provider business mailing address

4470 W 78TH STREET CIR STE 200
BLOOMINGTON MN
55435-5419
US

V. Phone/Fax

Practice location:
  • Phone: 612-298-2946
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: HAMDI KEYNAN
Title or Position: OWNER
Credential: RN
Phone: 651-395-9307