Nasra S Gonjobe

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

1056572-2-AFC Issued in MN

Legal business name

NASRA S GONJOBE

Doing business as

Nasra S Gonjobe and Abdi G Gonjobe

Practice address

1312 Burke Cir E
Maplewood, MN 55109-3450

Phone

(651) 230-9300

Fax

(651) 756-1696

NPI assigned

Aug 15, 2013

Organization subpart

No

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

Authorized official

Name

Abdi G Gonjobe

Title

Administrator

Phone

(651) 230-9300

Specialties & licenses 1

Addresses

Other names 1

• Nasra S Gonjobe and Abdi G Gonjobe Doing business as

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

{
    "created_epoch": "1376524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376524800000",
    "number": "1972936714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1312 BURKE CIR E",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551093450",
            "telephone_number": "651-230-9300",
            "fax_number": "651-756-1696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 BURKE CIR E",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551093450",
            "telephone_number": "651-230-9300",
            "fax_number": "651-756-1696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NASRA S GONJOBE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-15",
        "last_updated": "2013-08-15",
        "status": "A",
        "authorized_official_last_name": "GONJOBE",
        "authorized_official_first_name": "ABDI",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "651-230-9300"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "MN",
            "license": "1056572-2-AFC",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nasra S Gonjobe and Abdi G Gonjobe",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Adult Care Home Facility in Maplewood, MN
• Providers in Maplewood, MN by specialty
• Adult Care Home Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2013; 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.