Mina's Senior Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

MINA'S SENIOR LIVING LLC

Practice address

10163 Dormer Way
Elk Grove, CA 95757-1744

Phone

(916) 776-7060

NPI assigned

Jun 30, 2026

Organization subpart

No

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

Authorized official

Name

Mariatou Sisay

Title

Licensee

Phone

(916) 776-7060

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1782777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782777600000",
    "number": "1881511939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10163 DORMER WAY",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957571744",
            "telephone_number": "916-776-7060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10163 DORMER WAY",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957571744",
            "telephone_number": "916-776-7060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINA'S SENIOR LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-06-30",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A",
        "authorized_official_last_name": "SISAY",
        "authorized_official_first_name": "MARIATOU",
        "authorized_official_title_or_position": "LICENSEE",
        "authorized_official_telephone_number": "916-776-7060"
    },
    "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 Elk Grove, CA
• Providers in Elk Grove, CA by specialty
• Assisted Living Facility in California

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