Organization Active NPI

Golden Years Residence

  • Assisted Living Facility
  • Richfield, MN
National Provider Identifier
1245117571
Registry record updated Aug 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
GOLDEN YEARS RESIDENCE
Practice address
6528 Russell Ave S
Richfield, MN 55423-1057
Phone
(612) 930-0000
NPI assigned
Aug 19, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2025

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

Authorized official

Name
Mohamed S Hamsa
Title
Owner
Phone
(612) 930-0000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary
Skilled Nursing Facility 314000000X

Addresses

Primary practice location

6528 Russell Ave S
Richfield, MN 55423-1057

Mailing address

6528 Russell Ave S
Richfield, MN 55423-1057
Phone (612) 930-0000

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
24D2336084Golden Years Residence6528 Russell Ave, Richfield, MN 55423Certificate of waiverDec 22, 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": "1755561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756425600000",
    "number": "1245117571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6528 RUSSELL AVE S",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554231057",
            "telephone_number": "612-930-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6528 RUSSELL AVE S",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554231057",
            "telephone_number": "612-930-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN YEARS RESIDENCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-19",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-29",
        "status": "A",
        "authorized_official_last_name": "HAMSA",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-930-0000"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richfield, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.