Mission Group Home LLC

Primary specialty

Home Health AideTaxonomy code 374U00000X

Legal business name

MISSION GROUP HOME LLC

Practice address

730 N Van Buren Way
Hopkins, MN 55343-8145

Phone

(507) 210-5357

NPI assigned

May 10, 2020

Organization subpart

No

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

Authorized official

Name

Mohamed Ahmed Hassan

Title

Owner

Phone

(507) 210-5357

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1589068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589068800000",
    "number": "1902428287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 N VAN BUREN WAY",
            "city": "HOPKINS",
            "state": "MN",
            "postal_code": "553438145",
            "telephone_number": "507-210-5357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 N VAN BUREN WAY",
            "city": "HOPKINS",
            "state": "MN",
            "postal_code": "553438145",
            "telephone_number": "507-210-5357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION GROUP HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-10",
        "last_updated": "2020-05-10",
        "certification_date": "2020-05-10",
        "status": "A",
        "authorized_official_last_name": "HASSAN",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_middle_name": "AHMED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "507-210-5357"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Aide in Hopkins, MN
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• Home Health Aide in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2020; 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.