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General NPI Number Information
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NPI Number | 1992818231
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Entity Type | Organization
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Legal Business Name | HOMELAND HEALTH SPECIALISTS INC
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 1621 E HENNEPIN AVE STE 230
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City | MINNEAPOLIS
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State | MN
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Zip | 55414-2489
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Country | US
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Telephone | 763-746-8060
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Fax | 763-746-8063
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Provider Business Mailing Address
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Address Line | 1621 E HENNEPIN AVE STE 230
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City | MINNEAPOLIS
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State | MN
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Zip | 55414-2489
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Country | US
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Telephone | 763-746-8060
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Fax | 763-746-8063
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | THOMAS WISTED
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Credential |
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Telephone | 847-894-0774
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | R121223-7
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License Number State | MN
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