Prime Living MN LLC

Primary specialty

Assisted Living Facility (Behavioral Disturbances)Taxonomy code 3104A0630X

Legal business name

PRIME LIVING MN LLC

Practice address

2110 Wuthering Heights Rd
Eagan, MN 55122-1028

Phone

(443) 310-0126

NPI assigned

Feb 17, 2026

Last updated

Feb 17, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Mohamed I Mouhoumed

Title

Owner

Phone

(443) 310-0126

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1771286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771286400000",
    "number": "1376496612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 WUTHERING HEIGHTS RD",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551221028",
            "telephone_number": "443-310-0126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 WUTHERING HEIGHTS RD",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551221028",
            "telephone_number": "443-310-0126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME LIVING MN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-17",
        "last_updated": "2026-02-17",
        "certification_date": "2026-02-17",
        "status": "A",
        "authorized_official_last_name": "I MOUHOUMED",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-310-0126",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Premise Health of Minnesota Medical PC (Pipe Trades Services MN Family Health & Wellness Centers)
• Premise Health of Tennessee Medical PC (Your Well Being Health Center)
• Presence Telehealth PLLC (Compcare Urgent Care Eagan)
• Eric James Preslaski, PT
• Prime Care Homes LLC
• Prime Ride Transit, LLC
• Prime Therapeutics LLC
• Priority Care Homes LLC
• Proact, Inc.
• Michael Proebstle, MA, LPC

• Assisted Living Facility (Behavioral Disturbances) in Eagan, MN
• Providers in Eagan, 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 17, 2026; 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.