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IMMACULATE HOME CARE LLC
NPI 1407364813
Home Health in St. Paul, MN

Active since January 19, 2018CLIA 24D2167399 · Waiver
3731 IDAHO AVENUE EAST, ST. PAUL, MN 55106(651) 666-2135(651) 666-2137 Get Directions Write a Review

NPPES record last updated: June 13, 2019. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Jun 13, 2019, Jan 19, 2018 (2 updates tracked since 2018).

About Immaculate Home Care Llc NPPES

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

IMMACULATE HOME CARE LLC (NPI 1407364813) is a healthcare organization registered as a home health in St. Paul, Minnesota and active in the NPI registry since January 2018. The organization holds a CLIA Waiver certificate valid through June 5, 2027 and lists Kayode Taiwo, Owner/manager, as its authorized official.

NPPES Registry Identity

NPI1407364813
Entity TypeOrganization
Primary Taxonomy251E00000X
Legal Business NameIMMACULATE HOME CARE LLC
Location Address3731 IDAHO AVENUE EASTSt. Paul, MN 55106
Mailing Address3731 Idaho Avenue EastSt. Paul, MN 55106 · (651) 666-2135 · Fax (651) 666-2137
Phone(651) 666-2135
Fax(651) 666-2137
Organization SubpartNo
Authorized OfficialKayode TaiwoOwner/manager · (763) 670-5597
Enumeration DateJanuary 19, 2018
Last NPPES UpdateJune 13, 20192 updates tracked since enumeration
✔ NPI 1407364813 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.
3731 IDAHO AVENUE EAST, St. Paul, MN 55106
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CLIA Laboratory Certificates CMS CLIA

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 24D2167399

Immaculate Home Care LLC · Saint Paul, MN
Active · expires Jun 5, 2027
CLIA Number24D2167399
Laboratory TypeAssisted Living Facility
Certificate Effective DateJune 6, 2025
Certificate Expiration DateJune 5, 2027
Laboratory DirectorKayode K. Taiwo
Laboratory Phone(651) 666-2135
Laboratory LocationImmaculate Home Care LLC1390 Beech Street, Saint Paul, MN 55106
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Immaculate Home Care LLC's NPI number?

The NPI number for Immaculate Home Care LLC is 1407364813. It was assigned to this organization in the NPPES registry on January 19, 2018.

Where is Immaculate Home Care LLC located?

Immaculate Home Care LLC is located at 3731 Idaho Avenue East, St. Paul, MN 55106. The listed phone number is (651) 666-2135.

What is Immaculate Home Care LLC's specialty?

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

Does Immaculate Home Care LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D2167399) is associated with this NPI, valid through June 5, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Immaculate Home Care LLC was last updated on June 13, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.