Healthcare Provider Details

I. General information

NPI: 1982523932
Provider Name (Legal Business Name): MEDSTAR HOME SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3533 CEDAR AVE S
MINNEAPOLIS MN
55407-2338
US

IV. Provider business mailing address

3533 CEDAR AVE S
MINNEAPOLIS MN
55407-2338
US

V. Phone/Fax

Practice location:
  • Phone: 612-919-5496
  • Fax:
Mailing address:
  • Phone: 612-919-5496
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. NAWAL ABDILLAHI OSOBLE
Title or Position: OWNER
Credential:
Phone: 612-919-5496