NPIMap

Organization Active NPI

Tru Healthcare, Inc.

Doing business as HealthStar Home Health

  • In Home Supportive Care Agency
  • Arden Hills, MN
National Provider Identifier
1982702932
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
TRU HEALTHCARE, INC.
Doing business as
HealthStar Home Health
TRU Home Health
Practice address
3900 Northwoods Dr Ste 240
Arden Hills, MN 55112-6991
Phone
(651) 285-0135
Fax
(651) 633-7301
NPI assigned
Sep 20, 2006
Last updated
Sep 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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

Authorized official

Name
Tim Lively
Title
President
Phone
(651) 789-8769

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103G00000X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X
Home Health Agency 251E00000X 430029700 MN
In Home Supportive Care Agency 253Z00000X Primary
Multi-Specialty Clinic/Center 261QM1300X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

3900 Northwoods Dr Ste 240
Arden Hills, MN 55112-6991

Mailing address

3900 Northwoods Dr Ste 240
Arden Hills, MN 55112-6991
Phone (651) 285-0135

Other practice location 1

14525 Highway 7 Ste 250
Minnetonka, MN 55345-3734
Phone (612) 274-7290

Other names 2

  • HealthStar Home Health Doing business as
  • TRU Home Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100827000373 MN Part A Provider - Home Health Agency 0941324958 Practice locations: Arden Hills, MN; Bemidji, MN; Duluth, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1982702932. Details of each certification follow.

Home health agency certification: CCN 248124

Legal name
TRU HEALTHCARE INC
Doing business as
TRU HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Feb 13, 2012
Last certification
Sep 26, 2018
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Enrollment address
3900 Northwoods Dr
Ste 240
Arden Hills, MN 55112-6991

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

  • Tru Healthcare, Inc.

    dba TRU Wellness Center

    • Mental Health Clinic/Center (Including Community Mental Health Center)
    • Gilbert, AZ
    • NPI 1386016822

    0941324958

    Same PAC ID

Care Compare: Home health agency

Medicare Care Compare
Listed as
Tru Healthcare, IncCCN 248124 · All quality measures
Overall star rating
3 of 5
Ownership
Proprietary
Certified
Feb 13, 2012
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Healthstar Home Health2 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.

  • Tru Healthcare, Inc.

    dba TRU Wellness Center

    • Mental Health Clinic/Center (Including Community Mental Health Center)
    • Arden Hills, MN
    • NPI 1659819308
    NPD tax ID

Locations

807 Cloquet Ave
Ste 200
Cloquet, MN 55720
Phone (218) 392-0023

5810 Blackshire Path
Inver Grove Heights, MN 55076
Phone (612) 261-7300

407 Main St E
Ogema, MN 56569
Phone (218) 983-3900

742 1st St S
Ste 105
Waite Park, MN 56387
Phone (320) 240-6869

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Barbara a Jezorski Individual Corporate DirectorExecutive Director Jun 30, 2014 50%
Operational/Managerial ControlExecutive Director May 1, 2015 50%
Timothy C Lively Individual 5% Or Greater Direct Ownership InterestOwner Jul 16, 2010 100%
Corporate Officer Jul 16, 2010
Corporate DirectorPresident Jul 16, 2010
W-2 Managing Employee Jul 16, 2010

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 25

Affiliated clinicians 13

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726185600000",
    "number": "1982702932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 NORTHWOODS DR STE 240",
            "city": "ARDEN HILLS",
            "state": "MN",
            "postal_code": "551126991",
            "telephone_number": "651-285-0135",
            "fax_number": "651-633-7301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 NORTHWOODS DR STE 240",
            "city": "ARDEN HILLS",
            "state": "MN",
            "postal_code": "551126991",
            "telephone_number": "651-285-0135",
            "fax_number": "651-633-7301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14525 Highway 7 Ste 250",
            "address_purpose": "LOCATION",
            "city": "Minnetonka",
            "state": "MN",
            "postal_code": "553453734",
            "country_code": "US",
            "telephone_number": "612-274-7290",
            "fax_number": "612-274-7296",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TRU HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A",
        "authorized_official_last_name": "LIVELY",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-789-8769"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MN",
            "license": "430029700",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HealthStar Home Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "HealthStar Home Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "TRU Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Arden Hills, MN

Sources for this page

Verify at the official NPI Registry.