Healthcare Provider Details

I. General information

NPI: 1669387924
Provider Name (Legal Business Name): RADIANCE HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3531 COHANSEY ST
SHOREVIEW MN
55126-3907
US

IV. Provider business mailing address

3531 COHANSEY ST
SHOREVIEW MN
55126-3907
US

V. Phone/Fax

Practice location:
  • Phone: 612-441-1926
  • Fax:
Mailing address:
  • Phone: 612-441-1926
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ANENEG C SEINO
Title or Position: OWNER/DON
Credential:
Phone: 612-207-8841