Healthcare Provider Details

I. General information

NPI: 1619350436
Provider Name (Legal Business Name): ROLEN CARES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2015
Last Update Date: 02/25/2025
Certification Date: 02/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 CLOQUET AVE STE 3
CLOQUET MN
55720-1655
US

IV. Provider business mailing address

1111 CLOQUET AVE STE 3
CLOQUET MN
55720-1655
US

V. Phone/Fax

Practice location:
  • Phone: 218-727-1111
  • Fax: 218-720-6819
Mailing address:
  • Phone: 218-727-1111
  • Fax: 218-720-6819

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

VIII. Authorized Official

Name: STEFAN STAMENKOVIC
Title or Position: ADMINISTRATOR
Credential:
Phone: 651-746-9432