Organization
HOME CARE MINNESOTA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELLE CLERMONT KANNEH (VICE-PRESIDENT)
(612) 709-3880
Entity
Organization
Contact information
Practice address
6126 RADFORD AVE NE, OTSEGO, MN 55330-2976
(612) 709-3880
Mailing address
6126 RADFORD AVE NE, OTSEGO, MN 55330-2976
(612) 709-3880
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
—
—
251E00000X
Home Health Agency
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Enumeration date
07/13/2023
Last updated
12/15/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us