NORTHEASTERN HOME GROUP LLC NPI 1871344523

NPI Information

  • NPI: 1871344523
  • Provider Name: NORTHEASTERN HOME GROUP LLC
  • Classification: Assisted Living Facility - 3104A0625X
  • Specialization: Assisted Living, Mental Illness
  • Entity Type: Organization
  • Address: 10255 GREENBRIER RD APT 122
    MINNETONKA, MN
    ZIP 55305
  • Phone: (612) 442-4590

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NPI Details

NORTHEASTERN HOME GROUP LLC is an assisted living and mental illness assisted living facility in Minnetonka, MN. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. NORTHEASTERN HOME GROUP LLC NPI is 1871344523. The provider is registered as an organization entity type.

The provider's business location address is:

10255 GREENBRIER RD APT 122
MINNETONKA, MN
ZIP 55305-425
Phone: (612) 442-4590

The provider's authorized official is Fadumo Omar Jama .
The authorized official title is Director and has the following contact phone number (612) 203-2394.

The enumeration date for this NPI number is 4/1/2024 and was last updated on 4/1/2024.

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
13104A0625XAssisted Living FacilityAssisted Living, Mental IllnessYes

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: 3/30/2025

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