MEDICARE: BS HOMECARE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251J00000X	Nursing Care Agency
2	253Z00000X	In Home Supportive Care Agency
3	343900000X	Non-emergency Medical Transport (VAN)
4	372600000X	Adult Companion
5	376J00000X	Homemaker
6	385H00000X	Respite Care
7	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1225658891
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BS HOMECARE INC

Provider Business Mailing Address
First Line	:	20 LAKE ST N STE 308
Second Line	:
City	:	FOREST LAKE
State	:	MN
Zip	:	55025-2512
Country	:	US
Telephone Number	:	763-689-8984
Fax Number	:	763-689-1170

Provider Business Practice Location Address
First Line	:	20 LAKE ST N STE 308
Second Line	:
City	:	FOREST LAKE
State	:	MN
Zip	:	55025-2512
Country	:	US
Telephone Number	:	763-689-8984
Fax Number	:	763-689-1170

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MATT BRUNNETTE
Credential	:
Telephone Number	:	763-689-8984

Provider Enumeration Date	:	04/23/2020
Last Update Date	:	10/13/2023

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Directions to “BS HOMECARE INC ” Practice Location

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