Organization
COMPASSIONATE HOME CARE LTD
Active
Other names
Compassionate Home Care LTD LTD
Organization subpart
No
Provider details
NPI number
Authorized official
JAN MARIE NICODEMUS (OWNER)
(763) 238-5215
Entity
Organization
Contact information
Practice address
12950 FREMONT AVE STE 102, ZIMMERMAN, MN 55398-4629
(763) 238-5215
(763) 374-7161
Mailing address
12950 FREMONT AVE STE 102, ZIMMERMAN, MN 55398-4629
(763) 238-5215
(763) 374-7161
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
Primary
32519
MN
251J00000X
Nursing Care Agency
32519
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1083146344
HOME HEALTH AGENCY
MN
01
—
15416
HOME HEALTH AGENCY
WY
05
—
248165
—
MN
Enumeration date
03/28/2017
Last updated
11/11/2025
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