Crescent Care LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

CRESCENT CARE LLC

Practice address

13415 54TH Ave N
Plymouth, MN 55442-1767

Phone

(763) 998-6184

NPI assigned

May 13, 2026

Organization subpart

No

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

Authorized official

Name

Cubaydulah Noridin Abdulkadir

Title

Executive Director

Phone

(612) 232-9237

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1778630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778630400000",
    "number": "1679401046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13415 54TH AVE N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554421767",
            "telephone_number": "763-998-6184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13415 54TH AVE N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554421767",
            "telephone_number": "763-998-6184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESCENT CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-13",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A",
        "authorized_official_last_name": "ABDULKADIR",
        "authorized_official_first_name": "CUBAYDULAH",
        "authorized_official_middle_name": "NORIDIN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "612-232-9237"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Plymouth, MN
• Providers in Plymouth, 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 May 13, 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.