Antique Gardens Senior Care LLC
Organization Active NPI Assisted Living Facility · Brooklyn Park, MN
NPI 1093672180 · NPPES record last updated Jan 8, 2026
Key facts
- NPI
- 1093672180
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Assisted Living Facility 310400000X
- Legal business name
- ANTIQUE GARDENS SENIOR CARE LLC
- Practice address
- 6617 76TH Ave N
Brooklyn Park, MN 55428-1435 - Phone
- (763) 260-7298
- Fax
- (612) 484-4413
- NPI assigned
- Jan 8, 2026
- Organization subpart
- No
Authorized official
- Name
- Jawahir Ahmed
- Title
- Ceo
- Phone
- (763) 260-7298
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 24D2331747 | Antique Gardens Senior Care LLC | Certificate of waiver | Oct 7, 2027 |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | Yes |
Addresses
Primary practice location
6617 76TH Ave N
Brooklyn Park, MN 55428-1435
Mailing address
6617 76TH Ave N
Brooklyn Park, MN 55428-1435
Phone (763) 260-7298
Other providers in Brooklyn Park, MN
- Angelsisters Home Healthcare Servies LLC
- Augustine Onyekachi Ani
- Anjar Corporation
- Kouadio-Assi Anon
- Ayan Anshur
- Aplus Healthcare
- Arc Care Non-Emergency Medical Transportation LLC
- Arise Homecare Services PLLC
- Brooke Armstrong
- Karen A. Arrett
All providers in Brooklyn Park, MN · Assisted Living Facility in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 8, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.