TRISTAR HOME CARE LLC
NPI 1649779828
Assisted Living Facility in Brooklyn Park, MN

Q: What is Tristar Home Care LLC's NPI number?

The NPI number for Tristar Home Care LLC is 1649779828. It was assigned to this organization in the NPPES registry on February 2, 2018.

Q: What is Tristar Home Care LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Active since February 02, 2018CLIA 24D2262304 · Waiver

3000 80TH AVE N, BROOKLYN PARK, MN 55444(763) 415-5471(763) 292-9041 Get Directions Write a Review

NPPES record last updated: January 25, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 25, 2023, Sep 19, 2019, Jan 4, 2019 (3 updates tracked since 2019).

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About Tristar Home Care Llc NPPES

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

TRISTAR HOME CARE LLC (NPI 1649779828) is a healthcare organization registered as an assisted living facility in Brooklyn Park, Minnesota and active in the NPI registry since February 2018. The organization holds a CLIA Waiver certificate valid through June 12, 2028 and lists Raphael Ozurumba, Administrator, as its authorized official.

NPPES Registry Identity

NPI1649779828

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameTRISTAR HOME CARE LLC

Location Address3000 80TH AVE NBrooklyn Park, MN 55444-1836

Mailing Address9402 93rd St SCottage Grove, MN 55016-4096 · (763) 415-5471 · Fax (763) 204-8141

Phone(763) 415-5471

Fax(763) 292-9041

Organization SubpartNo

Authorized OfficialRaphael OzurumbaAdministrator · (651) 336-6815

Enumeration DateFebruary 2, 2018

Last NPPES UpdateJanuary 25, 20233 updates tracked since enumeration

NPPES CertifiedJanuary 25, 2023

✔ NPI 1649779828 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities

Taxonomy Code310400000X

Definition

A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

Also ListedHome HealthTaxonomy 251E00000X · License 385032 (MN)

3000 80TH AVE N, Brooklyn Park, MN 55444

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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 24D2262304

Tristar Home Care LLC · Brooklyn Park, MN

Active · expires Jun 12, 2028

CLIA Number24D2262304

Laboratory TypeAssisted Living Facility

Certificate Effective DateJune 13, 2026

Certificate Expiration DateJune 12, 2028

Laboratory DirectorRaphael C. Ozurumba

Laboratory Phone(763) 415-5471

Laboratory LocationTristar Home Care LLC3000 80th Ave N, Brooklyn Park, MN 55444

CLIA data matches this NPI record on: Address 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 Tristar Home Care LLC's NPI number?

The NPI number for Tristar Home Care LLC is 1649779828. It was assigned to this organization in the NPPES registry on February 2, 2018.

Where is Tristar Home Care LLC located?

Tristar Home Care LLC is located at 3000 80th Ave N, Brooklyn Park, MN 55444. The listed phone number is (763) 415-5471.

What is Tristar Home Care LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Tristar Home Care LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D2262304) is associated with this NPI, valid through June 12, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Tristar Home Care LLC was last updated on January 25, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.