Healthcare Provider Details

I. General information

NPI: 1831029354
Provider Name (Legal Business Name): STELLAR HOMEHEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7509 XENIA LN N
BROOKLYN PARK MN
55443-3145
US

IV. Provider business mailing address

7509 XENIA LN N
BROOKLYN PARK MN
55443-3145
US

V. Phone/Fax

Practice location:
  • Phone: 513-338-6689
  • Fax: 513-338-6689
Mailing address:
  • Phone: 513-338-6689
  • Fax: 513-338-6689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MATILDA KIMA
Title or Position: CEO
Credential: CEO
Phone: 513-338-6689