Vaimar Suites LLC

Primary specialty

Assisted Living Facility (Behavioral Disturbances)Taxonomy code 3104A0630X

Legal business name

VAIMAR SUITES LLC

Practice address

7900 Douglas Dr N
Brooklyn Park, MN 55443-2046

Phone

(763) 432-3008

NPI assigned

May 26, 2020

Organization subpart

No

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

Authorized official

Name

Martin S Mumbuwa

Title

Administrator/Owner

Phone

(952) 221-7318

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1590451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590451200000",
    "number": "1609499664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4845 FERNCROFT DR",
            "city": "EXCELSIOR",
            "state": "MN",
            "postal_code": "553318750",
            "telephone_number": "952-221-7318",
            "fax_number": "651-521-4223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 DOUGLAS DR N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554432046",
            "telephone_number": "763-432-3008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAIMAR SUITES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-26",
        "last_updated": "2020-05-26",
        "certification_date": "2020-05-26",
        "status": "A",
        "authorized_official_last_name": "MUMBUWA",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "ADMINISTRATOR/OWNER",
        "authorized_official_telephone_number": "952-221-7318"
    },
    "taxonomies": [
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility (Behavioral Disturbances) in Brooklyn Park, MN
• Providers in Brooklyn Park, 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 May 26, 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.