Healthcare Provider Details

I. General information

NPI: 1588599765
Provider Name (Legal Business Name): WELLDERLY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14501 NOWTHEN BLVD NW
RAMSEY MN
55303-6151
US

IV. Provider business mailing address

3117 8TH AVE
ANOKA MN
55303-1477
US

V. Phone/Fax

Practice location:
  • Phone: 763-202-4084
  • Fax:
Mailing address:
  • Phone: 763-443-1262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CATHERINE KAMMERER
Title or Position: DIRECTOR, FOUNDER
Credential: CDP
Phone: 763-443-1262