Diversity Wellness Center LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

DIVERSITY WELLNESS CENTER LLC

Practice address

1405 Lilac Dr N Ste 150G
Golden Valley, MN 55422-4536

Phone

(612) 598-2515

Fax

(612) 808-1814

NPI assigned

Sep 5, 2024

Organization subpart

No

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

Authorized official

Name

Maymuna Abdulkadir Mohamud

Title

Owner

Phone

(612) 598-2515

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1725494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782000000000",
    "number": "1487489662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 LILAC DR N STE 150G",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224536",
            "telephone_number": "612-598-2515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 LILAC DR N STE 150G",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224536",
            "telephone_number": "612-598-2515",
            "fax_number": "612-808-1814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSITY WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-05",
        "last_updated": "2026-06-21",
        "certification_date": "2026-06-21",
        "status": "A",
        "authorized_official_last_name": "MOHAMUD",
        "authorized_official_first_name": "MAYMUNA",
        "authorized_official_middle_name": "ABDULKADIR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-598-2515"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Golden Valley, MN
• Providers in Golden Valley, MN by specialty
• Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.