Healthcare Provider Details

I. General information

NPI: 1497433528
Provider Name (Legal Business Name): HOME CARE MINNESOTA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2023
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6126 RADFORD AVE NE
OTSEGO MN
55330-2976
US

IV. Provider business mailing address

6126 RADFORD AVE NE
OTSEGO MN
55330-2976
US

V. Phone/Fax

Practice location:
  • Phone: 612-607-4152
  • Fax:
Mailing address:
  • Phone: 612-607-4152
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. BARBARA BEECHER
Title or Position: PRESIDENT
Credential:
Phone: 612-607-4152