Organization Active NPI

Lenox Homes LLC

  • Assisted Living Facility
  • St Louis Park, MN
National Provider Identifier
1245042589
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
LENOX HOMES LLC
Practice address
2624 Xylon Ave S
St Louis Park, MN 55426-2473
Phone
(801) 702-6860
NPI assigned
Jan 23, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Authorized official

Name
Mohamed Abdirahman Samatar
Title
Manager
Phone
(801) 702-6860

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

2624 Xylon Ave S
St Louis Park, MN 55426-2473

Mailing address

2624 Xylon Ave S
St Louis Park, MN 55426-2473
Phone (801) 702-6860

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D2331637Lenox Homes LLC2624 Xylon Ave S, Saint Louis Park, MN 55426Certificate of waiverOct 5, 2027

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1737590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737590400000",
    "number": "1245042589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2624 XYLON AVE S",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554262473",
            "telephone_number": "801-702-6860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2624 XYLON AVE S",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554262473",
            "telephone_number": "801-702-6860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LENOX HOMES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-23",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A",
        "authorized_official_last_name": "SAMATAR",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_middle_name": "ABDIRAHMAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "801-702-6860"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; 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.