Healthcare Provider Details

I. General information

NPI: 1932043189
Provider Name (Legal Business Name): ALL STAR CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2026
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 MAIN ST NW STE 235
COON RAPIDS MN
55448-1104
US

IV. Provider business mailing address

3200 MAIN ST NW STE 235
COON RAPIDS MN
55448-1104
US

V. Phone/Fax

Practice location:
  • Phone: 612-600-6967
  • Fax: 612-460-9877
Mailing address:
  • Phone: 612-600-7411
  • Fax: 612-460-9877

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: HERSI ADAM
Title or Position: MANAGER
Credential:
Phone: 612-600-6967