Optimal Home of Maple Grove

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

OPTIMAL HOME OF MAPLE GROVE

Practice address

9261 Forestview LN N
Maple Grove, MN 55369-3944

Phone

(773) 951-0691

NPI assigned

Aug 17, 2024

Organization subpart

No

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

Authorized official

Name

Sumayo Mohamud

Title

Administrator

Phone

(773) 951-0691

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

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

{
    "created_epoch": "1723852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723852800000",
    "number": "1477385441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9261 FORESTVIEW LN N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553693944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9261 FORESTVIEW LN N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553693944",
            "telephone_number": "773-951-0691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMAL HOME OF MAPLE GROVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-17",
        "last_updated": "2024-08-17",
        "certification_date": "2024-08-16",
        "status": "A",
        "authorized_official_last_name": "MOHAMUD",
        "authorized_official_first_name": "SUMAYO",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "773-951-0691"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Assisted Living Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.