The Friendship Home Community, LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

24337 Issued in MN

Legal business name

THE FRIENDSHIP HOME COMMUNITY, LLC

Practice address

947 Lydia Dr W
Roseville, MN 55113-1923

Phone

(651) 398-2294

Fax

(651) 528-6216

NPI assigned

May 20, 2010

Organization subpart

No

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

Authorized official

Name

Mrs. Victoria Elizabeth Johansson

Title

Owner/Director

Phone

(651) 398-2294

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

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

{
    "created_epoch": "1274313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274313600000",
    "number": "1194044875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "947 LYDIA DR W",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551131923",
            "telephone_number": "651-398-2294",
            "fax_number": "651-528-6216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "947 LYDIA DR W",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551131923",
            "telephone_number": "651-398-2294",
            "fax_number": "651-528-6216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE FRIENDSHIP HOME COMMUNITY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-20",
        "last_updated": "2010-05-20",
        "status": "A",
        "authorized_official_last_name": "JOHANSSON",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "651-398-2294",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "MN",
            "license": "24337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Care Home Facility in Roseville, MN
• Providers in Roseville, MN by specialty
• Adult Care Home Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2010; 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.