NPIMap

Organization Active NPI

Fortunate Homes LLC

  • Assisted Living Facility
  • Brooklyn Center, MN
National Provider Identifier
1174102032
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
FORTUNATE HOMES LLC
Practice address
6124 Lee Ave N
Brooklyn Center, MN 55429-2476
Phone
(952) 994-5356
Fax
(952) 674-7774
NPI assigned
Apr 6, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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

Authorized official

Name
Susan N Obwaya
Title
Ceo/Owner
Phone
(952) 994-5356

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

6124 Lee Ave N
Brooklyn Center, MN 55429-2476

Mailing address

10875 131St Ave N
Champlin, MN 55316-1139
Phone (952) 674-7774

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address suzie@fortunatehomesllc.com Direct

National Provider Directory

National Provider Directory
Tax ID family
Fortunate Homes LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1617667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694390400000",
    "number": "1174102032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10875 131ST AVE N",
            "city": "CHAMPLIN",
            "state": "MN",
            "postal_code": "553161139",
            "telephone_number": "952-674-7774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6124 LEE AVE N",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554292476",
            "telephone_number": "952-994-5356",
            "fax_number": "952-674-7774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORTUNATE HOMES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-06",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A",
        "authorized_official_last_name": "OBWAYA",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "952-994-5356"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "suzie@fortunatehomesllc.com",
            "affiliation": "N",
            "endpointDescription": "Email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email address for contact person",
            "address_1": "6325 Xerxes Ave N",
            "city": "Brooklyn Center",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554302057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Sep 11, 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.

Verify at the official NPI Registry.