Home Care Minnesota LLC

Primary specialty

Registered NurseTaxonomy code 163W00000X

Legal business name

HOME CARE MINNESOTA LLC

Practice address

6126 Radford Ave NE
Otsego, MN 55330-2976

Phone

(612) 709-3880

NPI assigned

Jul 13, 2023

Last updated

Dec 15, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Angelle Clermont Kanneh

Title

Vice-President

Phone

(612) 709-3880

Specialties & licenses 5

Addresses

Tax ID family

Home Care Minnesota LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Home Care Minnesota LLC

  • Home Health Agency
  • Otsego, MN
  • NPI 1497433528
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1689206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765756800000",
    "number": "1881373223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6126 RADFORD AVE NE",
            "city": "OTSEGO",
            "state": "MN",
            "postal_code": "553302976",
            "telephone_number": "612-709-3880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6126 RADFORD AVE NE",
            "city": "OTSEGO",
            "state": "MN",
            "postal_code": "553302976",
            "telephone_number": "612-709-3880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME CARE MINNESOTA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-13",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A",
        "authorized_official_last_name": "KANNEH",
        "authorized_official_first_name": "ANGELLE",
        "authorized_official_middle_name": "CLERMONT",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "612-709-3880"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hjort Family Chiropractic, P.a.
• Laine Holcomb, PHARMD
• Kathryn Holland
• Page Holst, SLP
• Home Care Minnesota LLC
• Lynette Marie Hughs, PHARMD
• Melissa Husby Hursh
• Melodie Illies
• Infinite Health Collaborative, PA
• Integrity Independent Contracting, L.L.C.

• Registered Nurse in Otsego, MN
• Providers in Otsego, MN by specialty
• Registered Nurse in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.