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General NPI Number Information
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NPI Number | 1366334138
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Entity Type | Organization
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Legal Business Name | BLOOMINGTON HOME CARE SC
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Dates
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Enumeration Date | 07/16/2025
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | 10517 SHERIDAN AVE S
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City | BLOOMINGTON
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State | MN
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Zip | 55431-3461
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Country | US
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Telephone | 651-396-7159
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Fax |
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Provider Business Mailing Address
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Address Line | 10517 SHERIDAN AVE S
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City | BLOOMINGTON
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State | MN
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Zip | 55431-3461
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Country | US
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Telephone | 651-396-7159
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RAYMOND OSIOBE
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Credential |
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Telephone | 651-396-7159
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 3104A0630X
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Taxonomy Name | Assisted Living Facility (Behavioral Disturbances)
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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