Organization
TRISTAR HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAPHAEL OZURUMBA RN (ADMINISTRATOR)
(651) 336-6815
Entity
Organization
Contact information
Practice address
3000 80TH AVE N, BROOKLYN PARK, MN 55444-1836
(763) 415-5471
(763) 292-9041
Mailing address
9402 93RD ST S, COTTAGE GROVE, MN 55016-4096
(763) 415-5471
(763) 204-8141
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
385032
MN
251E00000X
Home Health Agency
—
—
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
02/02/2018
Last updated
01/25/2023
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