Organization
HOMELAND HEALTH SPECIALISTS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS WISTED (PRESIDENT & CEO)
(847) 894-0774
Entity
Organization
Contact information
Practice address
1621 E HENNEPIN AVE STE 230, MINNEAPOLIS, MN 55414-2489
(763) 746-8060
(763) 746-8063
Mailing address
1621 E HENNEPIN AVE STE 230, MINNEAPOLIS, MN 55414-2489
(763) 746-8060
(763) 746-8063
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
R121223-7
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1031834
PREFERRED ONE
—
01
—
164398
UCARE
MN
05
—
234933100
—
MN
01
—
4605640
BCBS OF MN
MN
01
—
8300115
MEDICA
—
01
—
870000829
HUMANA
—
01
—
87361
HEALTH PARTNERS
—
Enumeration date
08/17/2006
Last updated
06/04/2025
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