Pleasant Light LLC

Primary specialty

Assisted Living Facility (Behavioral Disturbances)Taxonomy code 3104A0630X

Legal business name

PLEASANT LIGHT LLC

Practice address

7765 Daleview Dr
Brooklyn Park, MN 55443-3330

Phone

(651) 500-8335

NPI assigned

Feb 23, 2024

Organization subpart

Yes

Parent organization

PLEASANT LIGHT LLCAs reported in NPPES

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

Authorized official

Name

Mr. Josphat Nyambati Omari

Title

Administrator

Phone

(651) 500-8335

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

Tax ID family

Pleasant Light LLC2 organizations share this tax ID, including this one

Part of

Pleasant Light LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Pleasant Light LLC

  • Home Health Agency
  • Burnsville, MN
  • NPI 1073153664
  NPD tax ID

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Pleasant Light LLC

  • Home Health Agency
  • Burnsville, MN
  • NPI 1073153664
  NPPES parent name

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

{
    "created_epoch": "1708646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708646400000",
    "number": "1366208704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14501 GRAND AVE APT 529",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553066604",
            "telephone_number": "651-500-8335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7765 DALEVIEW DR",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554433330",
            "telephone_number": "651-500-8335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLEASANT LIGHT LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PLEASANT LIGHT LLC",
        "enumeration_date": "2024-02-23",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-23",
        "status": "A",
        "authorized_official_last_name": "OMARI",
        "authorized_official_first_name": "JOSPHAT",
        "authorized_official_middle_name": "NYAMBATI",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "651-500-8335",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility (Behavioral Disturbances) in Brooklyn Park, MN
• Providers in Brooklyn Park, MN by specialty
• Assisted Living Facility (Behavioral Disturbances) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2024; 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.