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LIFESPARK HOME HEALTH LLC
NPI 1316318488
Home Health in St Louis Park, MN

Active since October 14, 2015CLIA Certified · 2 labs
5320 W 23RD ST STE 130, ST LOUIS PARK, MN 55416(952) 345-8770(612) 351-4050 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Lifespark Home Health Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LIFESPARK HOME HEALTH LLC (NPI 1316318488) is a healthcare organization registered as a home health in St Louis Park, Minnesota and active in the NPI registry since October 2015. The organization holds 2 active CLIA laboratory certificates and lists Staci Boehmer, Billing Manager, as its authorized official.

NPPES Registry Identity

NPI1316318488
Entity TypeOrganization
Primary Taxonomy251E00000X
Legal Business NameLIFESPARK HOME HEALTH LLC
Location Address5320 W 23RD ST STE 130St Louis Park, MN 55416-1670
Mailing Address5320 W 23rd St Ste 130St Louis Park, MN 55416-1670 · (952) 345-8770 · Fax (612) 351-4050
Phone(952) 345-8770
Fax(612) 351-4050
Organization SubpartNo
Authorized OfficialStaci BoehmerBilling Manager · (952) 428-7295
Enumeration DateOctober 14, 2015
Last NPPES UpdateJuly 21, 2022
NPPES CertifiedJuly 21, 2022
✔ NPI 1316318488 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyHome HealthAgencies
Taxonomy Code251E00000X
Definition
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.
5320 W 23RD ST STE 130, St Louis Park, MN 55416
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CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 24D1054400

Lifespark · Saint Louis Park, MN
Active · expires May 18, 2028
CLIA Number24D1054400
Laboratory TypeHome Health Agency
Certificate Effective DateMay 19, 2026
Certificate Expiration DateMay 18, 2028
Laboratory DirectorPaulette Duncan
Laboratory Phone(952) 345-8770
Laboratory LocationLifespark5320 W 23rd St Ste 130, Saint Louis Park, MN 55416
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 24D2103728

Lifespark · Saint Louis Park, MN
Active · expires Oct 19, 2027
CLIA Number24D2103728
Laboratory TypeHome Health Agency
Certificate Effective DateOctober 20, 2025
Certificate Expiration DateOctober 19, 2027
Laboratory DirectorCarol Stanley
Laboratory Phone(952) 345-8770
Laboratory LocationLifespark5320 W 23rd St Ste 130, Saint Louis Park, MN 55416
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AKHSA SIMONOVICH FNP
Nurse Practitioner (Family)
5320 W 23RD ST STE 130
ST LOUIS PARK, MN 55416
Hennepin County (952) 345-8770
WENDY LAINE MD
General Practice
5320 W 23RD ST STE 130
ST LOUIS PARK, MN 55416
Hennepin County (952) 345-3215
MRS. SHANNON O'GARA CNP
Nurse Practitioner (Adult Health)
5320 W 23RD ST STE 130
ST LOUIS PARK, MN 55416
Hennepin County (952) 345-3213
JOANNA WEINAND RD
Dietitian, Registered
5320 W 23RD ST STE 130
ST LOUIS PARK, MN 55416
Hennepin County (952) 345-3213
LIFESPARK HOSPICE, LLC
Hospice Care, Community Based
5320 W 23RD ST STE 130
ST LOUIS PARK, MN 55416
Hennepin County (952) 737-4350
ANDREW MICHAEL AESHLIMAN COTA
Occupational Therapy Assistant
5320 W 23RD ST STE 130
ST LOUIS PARK, MN 55416
Hennepin County (952) 345-8770
ELIZABETH ANN FEIERABEND MSN, FNP
Nurse Practitioner (Family)
5320 W 23RD ST STE 130
ST LOUIS PARK, MN 55416
Hennepin County (952) 345-8770
MRS. AMBER MICHELLE ROSENDAHL
Nurse Practitioner (Gerontology)
5320 W 23RD ST STE 130
ST LOUIS PARK, MN 55416
Hennepin County (952) 345-8770

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lifespark Home Health LLC's NPI number?

The NPI number for Lifespark Home Health LLC is 1316318488. It was assigned to this organization in the NPPES registry on October 14, 2015.

Where is Lifespark Home Health LLC located?

Lifespark Home Health LLC is located at 5320 W 23rd St Ste 130, St Louis Park, MN 55416. The listed phone number is (952) 345-8770.

What is Lifespark Home Health LLC's specialty?

The primary specialty registered for this NPI is Home Health with taxonomy code 251E00000X.

Does Lifespark Home Health LLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Lifespark Home Health LLC was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.