Provider Demographics
NPI:1225658891
Name:BS HOMECARE INC
Entity Type:Organization
Organization Name:BS HOMECARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUNNETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-689-8984
Mailing Address - Street 1:20 LAKE ST N STE 308
Mailing Address - Street 2:
Mailing Address - City:FOREST LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55025-2512
Mailing Address - Country:US
Mailing Address - Phone:763-689-8984
Mailing Address - Fax:763-689-1170
Practice Address - Street 1:20 LAKE ST N STE 308
Practice Address - Street 2:
Practice Address - City:FOREST LAKE
Practice Address - State:MN
Practice Address - Zip Code:55025-2512
Practice Address - Country:US
Practice Address - Phone:763-689-8984
Practice Address - Fax:763-689-1170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-23
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)Group - Multi-Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNA717902100Medicaid
MNA172457100Medicaid