Plateau Healthcare Laramie LLC

Primary specialty

Nursing Care AgencyTaxonomy code 251J00000X

Legal business name

PLATEAU HEALTHCARE LARAMIE LLC

Doing business as

PHC Laramie

Practice address

1817 Laramie TRL
Brooklyn Park, MN 55444-1902

Phone

(763) 444-1361

Fax

(763) 444-1358

NPI assigned

Aug 21, 2019

Organization subpart

No

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

Authorized official

Name

Mr. Faisale Boukari

Title

President

Phone

(763) 444-1361

Specialties & licenses 3

Addresses

Other names 1

• PHC Laramie Doing business as

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

{
    "created_epoch": "1566345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566345600000",
    "number": "1821645177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8848 ZEALAND AVE N STE B",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554451891",
            "telephone_number": "763-444-1361",
            "fax_number": "763-444-1358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1817 LARAMIE TRL",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554441902",
            "telephone_number": "763-444-1361",
            "fax_number": "763-444-1358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLATEAU HEALTHCARE LARAMIE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-21",
        "last_updated": "2019-08-21",
        "status": "A",
        "authorized_official_last_name": "BOUKARI",
        "authorized_official_first_name": "FAISALE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "763-444-1361",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHC Laramie",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amy Peterson, RN, BSN, PHN
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• Plateau Healthcare Mount Curve I LLC (PHC Mount Curve)
• Plateau Healthcare Mount Curve II, LLC (PHC Mount Curve II)
• Plateau Management, LLC
• Plateau Pca Services LLC
• Pleasant Light LLC

• Nursing Care Agency in Brooklyn Park, MN
• Providers in Brooklyn Park, MN by specialty
• Nursing Care Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2019; 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.