Healthcare Provider Details

I. General information

NPI: 1093382921
Provider Name (Legal Business Name): HEALTH AT HOME HOSPICE - MINNESOTA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2021
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7401 METRO BLVD STE 505
EDINA MN
55439-3038
US

IV. Provider business mailing address

901 HUGH WALLIS RD S
LAFAYETTE LA
70508-2511
US

V. Phone/Fax

Practice location:
  • Phone: 952-831-0193
  • Fax: 952-831-0191
Mailing address:
  • Phone: 337-233-1307
  • Fax: 337-443-4154

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: JOSHUA L. PROFFITT
Title or Position: PRESIDENT
Credential:
Phone: 337-233-1307