Organization Active NPI

Blessed Haven SC

  • Mental Illness Community Based Residential Treatment Facility
  • Minneapolis, MN
National Provider Identifier
1629831284
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
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

Updated by the provider on Feb 5, 2024

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

Authorized official

Name
Bureeqo O DahirNPI 1801662457
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)CodeLicenseStatePrimary
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 Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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.

Verify at the official NPI Registry.