Organization Active NPI

Azalea Homes

  • Assisted Living Facility
  • Champlin, MN
National Provider Identifier
1801501093
Registry record updated Aug 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
AZALEA HOMES
Practice address
11333 Welcome Ave N
Champlin, MN 55316-3445
Phone
(763) 321-4417
NPI assigned
Jan 23, 2023
Last updated
Aug 14, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2026

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

Authorized official

Name
Siamah Kanneh
Title
Co-Owner
Phone
(763) 273-0767

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU
Assisted Living Facility 310400000X NU Primary

Addresses

Primary practice location

11333 Welcome Ave N
Champlin, MN 55316-3445

Mailing address

5724 Pennsylvania Ave N
Crystal, MN 55428
Phone (763) 321-4417

Other practice location 1

5724 Pennsylvania Ave N
Crystal, MN 55428-3328
Phone (763) 321-4417

Other practice location 2

5857 Perry Ave N
Crystal, MN 55429
Phone (612) 702-0756

Other names 1

  • Azalea Homes LLC Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wecare@azaleahomes.org

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D2298167Azalea Homes LLC5857 Perry Ave N, Crystal, MN 55429Certificate of waiverJan 29, 2028

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1674432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786665600000",
    "number": "1801501093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5724 PENNSYLVANIA AVE N",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "55428",
            "telephone_number": "763-321-4417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11333 WELCOME AVE N",
            "city": "CHAMPLIN",
            "state": "MN",
            "postal_code": "553163445",
            "telephone_number": "763-321-4417"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5724 Pennsylvania Ave N",
            "address_purpose": "LOCATION",
            "city": "Crystal",
            "state": "MN",
            "postal_code": "554283328",
            "country_code": "US",
            "telephone_number": "763-321-4417",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5857 Perry Ave N",
            "address_purpose": "LOCATION",
            "city": "Crystal",
            "state": "MN",
            "postal_code": "55429",
            "country_code": "US",
            "telephone_number": "612-702-0756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AZALEA HOMES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-23",
        "last_updated": "2026-08-14",
        "certification_date": "2026-08-14",
        "status": "A",
        "authorized_official_last_name": "KANNEH",
        "authorized_official_first_name": "SIAMAH",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "763-273-0767"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wecare@azaleahomes.org",
            "affiliation": "N",
            "address_1": "5857 Perry Ave N",
            "city": "Crystal",
            "state": "MN",
            "country_code": "US",
            "postal_code": "55429",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Azalea Homes LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Champlin, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.