Active NPI
Blessed Haven SC
- Mental Illness Community Based Residential Treatment Facility
- Minneapolis, MN
National Provider Identifier
1629831284
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Illness Community Based Residential Treatment Facility
- Legal business name
- BLESSED HAVEN SC
- Doing business as
- Blessed Haven
- Practice address
- 3000 Logan Ave N
Minneapolis, MN 55411-1256 - Phone
- (612) 598-4075
- NPI assigned
- Feb 5, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Bureeqo O Dahir
- Title
- Owner
- Phone
- (612) 598-4075
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Illness Community Based Residential Treatment Facility | 320800000X | Primary |
Addresses
Primary practice location
3000 Logan Ave N
Minneapolis, MN 55411-1256
Mailing address
2855 Jordan Ave S Apt 209
Minnetonka, MN 55305-3507
Phone (612) 598-4075
Other names 1
- Blessed Haven
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Behavior Technician
- Minneapolis, MN
- NPI 1801662457
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707091200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1707091200000",
"number": "1629831284",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2855 JORDAN AVE S APT 209",
"city": "MINNETONKA",
"state": "MN",
"postal_code": "553053507",
"telephone_number": "612-598-4075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 LOGAN AVE N",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554111256",
"telephone_number": "612-598-4075"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BLESSED HAVEN SC",
"organizational_subpart": "NO",
"enumeration_date": "2024-02-05",
"last_updated": "2024-02-05",
"certification_date": "2024-02-05",
"status": "A",
"authorized_official_last_name": "DAHIR",
"authorized_official_first_name": "BUREEQO",
"authorized_official_middle_name": "O",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "612-598-4075"
},
"taxonomies": [
{
"code": "320800000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Mental Illness",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Blessed Haven",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.