Manasseh Home Healthcare LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

MANASSEH HOME HEALTHCARE LLC

Practice address

11555 Boulder CT
Maple Grove, MN 55311-7521

Phone

(612) 351-7100

NPI assigned

Mar 19, 2025

Organization subpart

No

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

Authorized official

Name

Jewel B JohnsonNPI 1336020353

Title

President

Phone

(612) 351-7100

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jewel Johnson

  • Nurse Practitioner
  • Maple Grove, MN
  • NPI 1336020353
  NPD Authorized official

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

{
    "created_epoch": "1742342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749600000000",
    "number": "1184425944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11555 BOULDER CT",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553117521",
            "telephone_number": "612-351-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11555 BOULDER CT",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553117521",
            "telephone_number": "612-351-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANASSEH HOME HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-19",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JEWEL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "612-351-7100"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan K. Mahle, M.D.
• Alicia Marie Malisheski, LICSW
• Blake Malloy
• Kirsten Malvey, WHNP
• Daniel Mark Mammel, MD
• Michelle Lynn Mandler
• Roger L Mann
• Dianne Marie Mansfield, PT
• Maple Grove Center for Restorative Surgery
• Maple Grove Center for Restorative Surgery LLC

• Home Health Agency in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Home Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2025; 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.