Organization Active NPI

Wellness Group Home Corporation

  • Assisted Living Facility
  • Brooklyn Center, MN
National Provider Identifier
1003460767
Registry record updated Apr 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
WELLNESS GROUP HOME CORPORATION
Practice address
2606 64TH Ave N
Brooklyn Center, MN 55430-2007
Phone
(612) 205-6554
NPI assigned
Jul 30, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Abdirashid J Arab
Title
Owner
Phone
(612) 205-6554

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X
Nursing Care Agency 251J00000X
Assisted Living Facility 310400000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X
Non-emergency Medical Transport (VAN) 343900000X

Addresses

Primary practice location

2606 64TH Ave N
Brooklyn Center, MN 55430-2007

Mailing address

2606 64TH Ave N
Brooklyn Center, MN 55430-2007
Phone (612) 205-6554

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D2190461Wellness Group Home Corporation2606 64TH Ave N, Brooklyn Center, MN 55430Certificate of waiverAug 12, 2026

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1564444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587945600000",
    "number": "1003460767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2606 64TH AVE N",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554302007",
            "telephone_number": "612-205-6554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2606 64TH AVE N",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554302007",
            "telephone_number": "612-205-6554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS GROUP HOME CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-30",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A",
        "authorized_official_last_name": "ARAB",
        "authorized_official_first_name": "ABDIRASHID",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-205-6554"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn Center, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.