PETRA HOMECARE SERVICES LLC NPI 1962395970

NPI Information

  • NPI: 1962395970
  • Provider Name: PETRA HOMECARE SERVICES LLC
  • Classification: Respite Care - 385H00000X
  • Entity Type: Organization
  • Address: 12856 MANKATO ST NE
    BLAINE, MN
    ZIP 55449
  • Phone: (612) 390-4489

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NPI Details

PETRA HOMECARE SERVICES LLC is a respite care in Blaine, MN. PETRA HOMECARE SERVICES LLC NPI is 1962395970. The provider is registered as an organization entity type.

The provider's business location address is:

12856 MANKATO ST NE
BLAINE, MN
ZIP 55449-936
Phone: (612) 390-4489

The provider's authorized official is Elizabeth Nana Yaa Fleck .
The authorized official title is Owner and has the following contact phone number (612) 390-4489.

The enumeration date for this NPI number is 5/29/2025 and was last updated on 5/29/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1253Z00000XIn Home Supportive CareNo
2261QM0850XClinic/CenterAdult Mental HealthNo
3251S00000XCommunity/Behavioral HealthNo
4251E00000XHome HealthNo
5251J00000XNursing CareNo
6385H00000XRespite CareYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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