Petra Homecare Services LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

PETRA HOMECARE SERVICES LLC

Practice address

12856 Mankato St NE
Blaine, MN 55449-4936

Phone

(612) 390-4489

NPI assigned

May 29, 2025

Organization subpart

No

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

Authorized official

Name

Elizabeth Nana Yaa Fleck, REGISTERED NURSE

Title

Owner

Phone

(612) 390-4489

Specialties & licenses 6

Addresses

Other names 1

• Petra Recuperative Care Services Doing business as

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

{
    "created_epoch": "1748476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784937600000",
    "number": "1962395970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12856 MANKATO ST NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554494936",
            "telephone_number": "612-390-4489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12856 MANKATO ST NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554494936",
            "telephone_number": "612-390-4489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETRA HOMECARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-29",
        "last_updated": "2026-07-25",
        "certification_date": "2026-07-25",
        "status": "A",
        "authorized_official_last_name": "FLECK",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "NANA YAA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-390-4489",
        "authorized_official_credential": "REGISTERED NURSE"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Petra Recuperative Care Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Paul H Peterson, DPM
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• Home Health Agency in Blaine, MN
• Providers in Blaine, MN by specialty
• Home Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2026; 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.