Healthcare Provider Details

I. General information

NPI: 1093684052
Provider Name (Legal Business Name): CHELSEA HOME SUPPORTS LIMITED LIABILITY COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2025
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2136 FORD PKWY STE 5081
SAINT PAUL MN
55116-2850
US

IV. Provider business mailing address

2136 FORD PKWY # 5081
SAINT PAUL MN
55116-2850
US

V. Phone/Fax

Practice location:
  • Phone: 210-439-5026
  • Fax:
Mailing address:
  • Phone: 210-439-5026
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: VADIM ABRASHEV
Title or Position: CEO
Credential:
Phone: 210-439-5026