MEDICARE: HOMELAND HEALTH SPECIALISTS INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WC1500X	Community Health Registered Nurse	R121223-7	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	164398	OTHER	MN	UCARE
2	8300115	OTHER		MEDICA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	4605640	OTHER	MN	BCBS OF MN
5	87361	OTHER		HEALTH PARTNERS
6	1031834	OTHER		PREFERRED ONE
7	870000829	OTHER		HUMANA

General Provider Information

NPI Number	:	1992818231
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOMELAND HEALTH SPECIALISTS INC

Provider Business Mailing Address
First Line	:	1621 E HENNEPIN AVE STE 230
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55414-2489
Country	:	US
Telephone Number	:	763-746-8060
Fax Number	:	763-746-8063

Provider Business Practice Location Address
First Line	:	1621 E HENNEPIN AVE STE 230
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55414-2489
Country	:	US
Telephone Number	:	763-746-8060
Fax Number	:	763-746-8063

Authorized Official
Title or Position	:	PRESIDENT & CEO
Name	:	THOMAS WISTED
Credential	:
Telephone Number	:	847-894-0774

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	06/04/2025

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