Safe Harbor LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

SAFE HARBOR LLC

Practice address

12031 Terrace CT NE
Blaine, MN 55434-3384

Phone

(612) 806-7860

NPI assigned

Oct 19, 2021

Organization subpart

No

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

Authorized official

Name

Umal-Khayr Abdirahman OmarNPI 1548938053

Title

Owner

Phone

(612) 806-7860

Specialties & licenses 1

Addresses

Practitioners 1

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

• Umal-Khayr Abdirahman Omar

  • Student in an Organized Health Care Education/Training Program
  • Blaine, MN
  • NPI 1548938053
  NPD Authorized official

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

{
    "created_epoch": "1634601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634601600000",
    "number": "1194488932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12031 TERRACE CT NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554343384",
            "telephone_number": "612-806-7860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12031 TERRACE CT NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554343384",
            "telephone_number": "612-806-7860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAFE HARBOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-19",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A",
        "authorized_official_last_name": "OMAR",
        "authorized_official_first_name": "UMAL-KHAYR",
        "authorized_official_middle_name": "ABDIRAHMAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-806-7860"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jeffrey Mark Ruhlmann
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• Health Service Clinic/Center in Blaine, MN
• Providers in Blaine, MN by specialty
• Health Service Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2021; 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.