Midwest Group Homes LLC

Primary specialty

Nursing Care AgencyTaxonomy code 251J00000X

Legal business name

MIDWEST GROUP HOMES LLC

Practice address

1411 W Saint Germain St Ste 6
Saint Cloud, MN 56301-4179

Phone

(320) 217-5302

Fax

(320) 217-5302

NPI assigned

Jun 28, 2020

Organization subpart

No

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

Authorized official

Name

Mahad Adam

Title

Owner

Phone

(320) 217-8700

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1593302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593302400000",
    "number": "1477170231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 W SAINT GERMAIN ST STE 6",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563014179",
            "telephone_number": "320-217-5302",
            "fax_number": "320-217-5302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 W SAINT GERMAIN ST STE 6",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563014179",
            "telephone_number": "320-217-5302",
            "fax_number": "320-217-5302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST GROUP HOMES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-28",
        "last_updated": "2020-06-28",
        "certification_date": "2020-06-28",
        "status": "A",
        "authorized_official_last_name": "ADAM",
        "authorized_official_first_name": "MAHAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "320-217-8700"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOME CARE LICENSE",
            "identifier": "396341",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nursing Care Agency in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• Nursing Care Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2020; 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.