Active NPI
Plateau Healthcare LLC
- Nursing Care Agency
- Brooklyn Center, MN
National Provider Identifier
1134431802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Care Agency
- License
- 372551
- Legal business name
- PLATEAU HEALTHCARE LLC
- Practice address
- 6424 June Ave N
Brooklyn Center, MN 55429-2127 - Phone
- (763) 444-1361
- Fax
- (763) 444-1358
- NPI assigned
- Jul 9, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Faisale Sale Boukari
- Title
- President
- Phone
- (763) 444-1361
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 352764 | MN | |
| Nursing Care Agency | 251J00000X | 352764 | MN | |
| Nursing Care Agency | 251J00000X | 372551 | MN | Primary |
| In Home Supportive Care Agency | 253Z00000X | 353611 | MN | |
| Assisted Living Facility | 310400000X |
Addresses
Primary practice location
6424 June Ave N
Brooklyn Center, MN 55429-2127
Mailing address
8848 Zealand Ave N Ste B
Brooklyn Park, MN 55445-1891
Phone (763) 444-1361
Other practice location 1
9962 104th Ave N
Maple Grove, MN 55369-2941
Phone (763) 444-1361 ext. 140
Other practice location 2
1817 Laramie Trl
Brooklyn Park, MN 55444-1902
Phone (763) 444-1361 ext. 130
Other practice location 3
7900 Mount Curve Blvd
Minneapolis, MN 55445-2352
Phone (763) 444-1361 ext. 150
Other practice location 4
7890 Mount Curve Blvd N
Brooklyn Park, MN 55445-3001
Phone (763) 444-1361
Other practice location 5
9923 Queen Cir
Bloomington, MN 55431-2847
Phone (763) 444-1361
Other names 1
- PHC Community
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Registered Nurse
- Champlin, MN
- NPI 1366755464
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278633600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1682640000000",
"number": "1134431802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8848 ZEALAND AVE N STE B",
"city": "BROOKLYN PARK",
"state": "MN",
"postal_code": "554451891",
"telephone_number": "763-444-1361",
"fax_number": "763-444-1358"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6424 JUNE AVE N",
"city": "BROOKLYN CENTER",
"state": "MN",
"postal_code": "554292127",
"telephone_number": "763-444-1361",
"fax_number": "763-444-1358"
}
],
"practiceLocations": [
{
"address_1": "9962 104th Ave N",
"address_purpose": "LOCATION",
"city": "Maple Grove",
"state": "MN",
"postal_code": "553692941",
"country_code": "US",
"telephone_number": "763-444-1361 x140",
"fax_number": "763-444-1358",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1817 Laramie Trl",
"address_purpose": "LOCATION",
"city": "Brooklyn Park",
"state": "MN",
"postal_code": "554441902",
"country_code": "US",
"telephone_number": "763-444-1361 x130",
"fax_number": "763-444-1358",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "7900 Mount Curve Blvd",
"address_purpose": "LOCATION",
"city": "Minneapolis",
"state": "MN",
"postal_code": "554452352",
"country_code": "US",
"telephone_number": "763-444-1361 x150",
"fax_number": "763-444-1358",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "7890 Mount Curve Blvd N",
"address_purpose": "LOCATION",
"city": "Brooklyn Park",
"state": "MN",
"postal_code": "554453001",
"country_code": "US",
"telephone_number": "763-444-1361",
"fax_number": "763-444-1358",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "9923 Queen Cir",
"address_purpose": "LOCATION",
"city": "Bloomington",
"state": "MN",
"postal_code": "554312847",
"country_code": "US",
"telephone_number": "763-444-1361",
"fax_number": "763-444-1358",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "PLATEAU HEALTHCARE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2010-07-09",
"last_updated": "2023-04-28",
"certification_date": "2023-04-28",
"status": "A",
"authorized_official_last_name": "BOUKARI",
"authorized_official_first_name": "FAISALE",
"authorized_official_middle_name": "SALE",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "763-444-1361"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "MN",
"license": "352764",
"primary": false
},
{
"code": "251J00000X",
"taxonomy_group": "",
"desc": "Nursing Care",
"state": "MN",
"license": "352764",
"primary": false
},
{
"code": "251J00000X",
"taxonomy_group": "",
"desc": "Nursing Care",
"state": "MN",
"license": "372551",
"primary": true
},
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": "MN",
"license": "353611",
"primary": false
},
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "PHC Community",
"code": "3",
"type": "Doing Business As"
}
]
}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 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.