Community Boarding Care

Primary specialty

Custodial Care FacilityTaxonomy code 311Z00000X

Legal business name

COMMUNITY BOARDING CARE

Practice address

2219 Oakland Ave # 110
Minneapolis, MN 55404-3749

Phone

(612) 296-3708

NPI assigned

Apr 24, 2014

Organization subpart

No

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

Authorized official

Name

Mohamed Bidare, DIRECTOR

Title

Owner

Phone

(612) 296-3708

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1398297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398297600000",
    "number": "1629498035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2219 OAKLAND AVE # 110",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554043749",
            "telephone_number": "612-296-3708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2219 OAKLAND AVE # 110",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554043749",
            "telephone_number": "612-296-3708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY BOARDING CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-24",
        "last_updated": "2014-04-24",
        "status": "A",
        "authorized_official_last_name": "BIDARE",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-296-3708",
        "authorized_official_credential": "DIRECTOR"
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2014; 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.