Organization Active NPI

Nestle Care LLC

  • Assisted Living Facility
  • St Louis Park, MN
National Provider Identifier
1861212136
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
NESTLE CARE LLC
Practice address
6019 W 39TH St
St Louis Park, MN 55416-2718
Phone
(612) 636-2338
NPI assigned
Oct 11, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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

Authorized official

Name
Maryan Abdikadir Isse, RN, MSN
Title
Owner
Phone
(612) 636-2338

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

6019 W 39TH St
St Louis Park, MN 55416-2718

Mailing address

6019 W 39TH St
St Louis Park, MN 55416-2718
Phone (612) 636-2338

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
24D2313538Nestle Care LLC6019 West 39TH Street, Saint Louis Park, MN 55416Certificate of waiverOct 31, 2026

National Provider Directory

National Provider Directory

Locations

6019 W 39th St
St Louis Park, MN 55416
Phone (612) 636-2338

NPI Registry JSON

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

{
    "created_epoch": "1728604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728604800000",
    "number": "1861212136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6019 W 39TH ST",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162718",
            "telephone_number": "612-636-2338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6019 W 39TH ST",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162718",
            "telephone_number": "612-636-2338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NESTLE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-11",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A",
        "authorized_official_last_name": "ISSE",
        "authorized_official_first_name": "MARYAN",
        "authorized_official_middle_name": "ABDIKADIR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-636-2338",
        "authorized_official_credential": "RN, MSN"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2024; 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.