Organization Active NPI

Kindheart Healthcare Services LLC

  • Early Intervention Provider Agency
  • Golden Valley, MN
National Provider Identifier
1376431205
Registry record updated Jun 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
KINDHEART HEALTHCARE SERVICES LLC
Practice address
1200 Mendelssohn Ave N Ste 104C
Golden Valley, MN 55427-4376
Phone
(612) 998-6012
NPI assigned
Jun 27, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2025

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

Authorized official

Name
Nimo Aw Ibrahim
Title
Owner
Phone
(612) 998-6012

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X Primary

Addresses

Primary practice location

1200 Mendelssohn Ave N Ste 104C
Golden Valley, MN 55427-4376

Mailing address

1200 Mendelssohn Ave N Ste 104C
Golden Valley, MN 55427-4376
Phone (612) 998-6012

National Provider Directory

National Provider Directory

Locations

1200 Mendelssohn Ave N
Ste 104C
Golden Valley, MN 55427
Phone (612) 998-6012

NPI Registry JSON

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

{
    "created_epoch": "1750982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750982400000",
    "number": "1376431205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 MENDELSSOHN AVE N STE 104C",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554274376",
            "telephone_number": "612-998-6012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 MENDELSSOHN AVE N STE 104C",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554274376",
            "telephone_number": "612-998-6012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINDHEART HEALTHCARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-27",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "NIMO",
        "authorized_official_middle_name": "AW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-998-6012"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Golden Valley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2025; 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.