Second Story LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SECOND STORY LLC

Practice address

1013 W River Rd
Champlin, MN 55316-2002

Phone

(763) 346-0311

NPI assigned

Apr 9, 2026

Last updated

Jul 30, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mukhtar Dahir

Title

Owner

Phone

(763) 346-0311

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1775692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785369600000",
    "number": "1659213361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5273 OAK GROVE PKWY N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554434401",
            "telephone_number": "763-346-0311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1013 W RIVER RD",
            "city": "CHAMPLIN",
            "state": "MN",
            "postal_code": "553162002",
            "telephone_number": "763-346-0311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SECOND STORY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-09",
        "last_updated": "2026-07-30",
        "certification_date": "2026-07-30",
        "status": "A",
        "authorized_official_last_name": "DAHIR",
        "authorized_official_first_name": "MUKHTAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "763-346-0311"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN DEPT OF HEALTH ASSISTED LIVING FACILITY LICENSE",
            "identifier": "425562",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Champlin, MN
• Providers in Champlin, MN by specialty
• Assisted Living Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.